Active NPI
Alice Elizabeth Benton, PSY.D.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1578761680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY23516
- Practice address
- 123 S Alvarado St
Los Angeles, CA 90057-2201 - Phone
- (213) 989-7700
- Fax
- (213) 989-7702
- NPI assigned
- Jul 10, 2007
- Last updated
- Dec 14, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Clinical Psychologist | 103TC0700X | PSY23516 | CA | Primary |
Addresses
Primary practice location
123 S Alvarado St
Los Angeles, CA 90057-2201
Mailing address
123 S Alvarado St
Los Angeles, CA 90057-2201
Phone (213) 989-7700
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05-1007 | Other | CA | MEDICARE ID |
| FHC71005F | Medicaid | CA | |
| FHC70567F | Medicaid | CA | |
| 05-1023 | Other | CA | MEDICARE ID |
Other names 1
- Dr. Alice Elizabeth Olson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355443200000",
"number": "1578761680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 S ALVARADO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572201",
"telephone_number": "213-989-7700",
"fax_number": "213-989-7702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 S ALVARADO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572201",
"telephone_number": "213-989-7700",
"fax_number": "213-989-7702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTON",
"first_name": "ALICE",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2012-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY23516",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "05-1007",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC71005F",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "FHC70567F",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "05-1023",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ALICE",
"last_name": "OLSON",
"middle_name": "ELIZABETH",
"prefix": "DR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.