Individual provider Active NPI

Daniel Skenderian, PH.D.

  • Clinical Psychologist
  • Claremont, CA
National Provider Identifier
1639235138
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY8083 Issued in CA
Practice address
350 W 4TH St
Claremont, CA 91711-4733
Phone
(909) 625-1123
Fax
(909) 625-6023
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY8083 CA Primary

Addresses

Primary practice location

350 W 4TH St
Claremont, CA 91711-4733

Mailing address

350 W, Fourth St.
Claremont, CA 91711-4733
Phone (909) 625-1123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100128000143 CA Practitioner - Psychologist Billing Independently 5991847089 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Claremont, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colina Medical Associates, Inc.Group PAC ID 1759511165, 2 clinicians

Practice addresses (Care Compare)

255 E Bonita Ave
Pomona, CA 91767-1923
Phone 90959677332170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Colina Medical Associates, Inc. CurrentSince Aug 22, 2015 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients

Locations

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

Interoperability endpoints

  • Direct secure messaging: clinic.casacolina@direct.casacolina.org
  • Direct secure messaging: casacolina@direct.casacolina.org

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639235138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W, FOURTH ST.",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114733",
            "telephone_number": "909-625-1123",
            "fax_number": "909-625-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W 4TH ST",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114733",
            "telephone_number": "909-625-1123",
            "fax_number": "909-625-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKENDERIAN",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.