Active NPI
Lanikai N Clouse, PSYD
- Psychologist
- Pasadena, CA
National Provider Identifier
1578728663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY21918
- Practice address
- 2810 E del Mar Blvd Ste 12
Pasadena, CA 91107-6709 - Phone
- (626) 585-0041
- Fax
- (626) 585-1839
- NPI assigned
- Jul 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY21918 | CA | Primary |
Addresses
Primary practice location
2810 E del Mar Blvd Ste 12
Pasadena, CA 91107-6709
Mailing address
4335 Van Nuys Blvd Ste 435
Sherman Oaks, CA 91403-3727
Phone (626) 585-0041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090224000298 | CA | Practitioner - Clinical Psychologist | 2466517578 | Practice locations: Pasadena, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2810 E del Mar Blvd
12 Carlson and Associates
Pasadena, CA 91107-6709
Phone (626) 584-0433
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21918 | CA | MD | Professional Counselor |
| PSY21918 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217203200000",
"number": "1578728663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4335 VAN NUYS BLVD STE 435",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914033727",
"telephone_number": "626-585-0041",
"fax_number": "626-585-1839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2810 E DEL MAR BLVD STE 12",
"city": "PASADENA",
"state": "CA",
"postal_code": "911076709",
"telephone_number": "626-585-0041",
"fax_number": "626-585-1839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLOUSE",
"first_name": "LANIKAI",
"middle_name": "N",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-28",
"last_updated": "2008-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY21918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.