Megan Christina Ichinose

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

33408 Issued in CA

Practice address

760 Westwood PLZ
Los Angeles, CA 90024-5055

Phone

(310) 825-2836

NPI assigned

Oct 17, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Centerstone of Tennessee, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manhattan, KS
  • NPI 1023900651
  NPD (past)
• Centerstone of Tennessee, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, TN
  • NPI 1396767430
  NPD (past)

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1629529466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "310-825-2836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 White Ave",
            "address_2": "Centerston",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372042235",
            "country_code": "US",
            "telephone_number": "615-460-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10850 Wilshire Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900244315",
            "country_code": "US",
            "telephone_number": "424-229-1683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICHINOSE",
        "first_name": "MEGAN",
        "middle_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "33408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iceberg Health Care Inc.
• Kathryn S. Icenhower, PHD, LCSW
• Icf Healthcare, Inc.
• Sara Noelani Iches
• Stephanie Gregorio Ichikawa, PHARMD
• Anne Marie Ichiuji, MD
• Brynne Ariye Ichiuji
• Mary M. Ichiuji, MD
• Trisha Leilani Ichiyama, LMT
• Jason Ickovitz, LMFT

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.