Kenneth Subotnik, PH.D., Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

PSY12770 Issued in CA

Legal business name

KENNETH SUBOTNIK, PH.D., INC

Practice address

10850 Wilshire Blvd Ste 240
Los Angeles, CA 90024-4308

Phone

(310) 824-4600

NPI assigned

Jun 2, 2008

Last updated

Jun 2, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth Lee Subotnik, PH.D.NPI 1790709335

Title

Director

Phone

(310) 824-4600

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth L Subotnik, PH.D.

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1790709335
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1598924953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 WILSHIRE BLVD STE 240",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244308",
            "telephone_number": "310-824-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 WILSHIRE BLVD STE 240",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244308",
            "telephone_number": "310-824-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH SUBOTNIK, PH.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "SUBOTNIK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-824-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CA",
            "license": "PSY12770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY127700",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA PSYCHOLOGIST LICENSE",
            "identifier": "PSY12770",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth C Nieberg MD Inc
• Kenneth C. Cooper (K C Medical)
• Kenneth H Thomas MD Inc
• Kenneth K Kim, a Medical Corporation
• Kenneth K. Kim, M.D., a Professional Medical Corporation
• Kenneth W Luther a Chiropracti (Mar Vista Institute of Health)
• Kenneth W. Cheng, DDS, Inc.
• Kenneth W. Luther Chiropractic Corp.
• Brittney Kenney
• E. Barrie Kenney, D.D.S.,M.S.

• Adult Mental Health Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.