Active NPI
Julie Mikashus, PSY.D.
- Clinical Psychologist
- Pasadena, CA
National Provider Identifier
1629109376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 17560
- Practice address
- 597 E Green St
Ste 202
Pasadena, CA 91101-5204 - Phone
- (626) 429-9261
- NPI assigned
- Mar 7, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 17560 | CA | Primary |
Addresses
Primary practice location
597 E Green St
Ste 202
Pasadena, CA 91101-5204
Mailing address
1721 Griffin Ave
Los Angeles, CA 90031-3062
Phone (323) 221-4134
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 |
|---|---|---|---|---|
| I20170621002226 | CA | Practitioner - Clinical Psychologist | 5496023178 | Practice locations: Pasadena, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
597 E Green St
Pasadena, CA 91101-5204
Phone (626) 429-9261
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 17560 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1629109376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 GRIFFIN AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900313062",
"telephone_number": "323-221-4134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "597 E GREEN ST",
"address_2": "STE 202",
"city": "PASADENA",
"state": "CA",
"postal_code": "911015204",
"telephone_number": "626-429-9261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKASHUS",
"first_name": "JULIE",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-07",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 17560",
"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 May 10, 2017; 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.