Active NPI
Nima Nouri, PSY.D.
- Clinical Psychologist
- Beverly Hills, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY27239
- Practice address
- 420 S Beverly Dr Ste 100-9
Beverly Hills, CA 90212-4426 - Phone
- (213) 223-7264
- Fax
- (310) 881-8628
- NPI assigned
- Jul 6, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | PSY27239 | CA | Primary |
| Rehabilitation Counselor | 225C00000X |
Addresses
Primary practice location
420 S Beverly Dr Ste 100-9
Beverly Hills, CA 90212-4426
Mailing address
420 S Beverly Dr Ste 100-9
Beverly Hills, CA 90212-4426
Phone (213) 223-7264
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
420 S Beverly Dr
Suite 100 9
Beverly Hills, CA 90212-4411
Phone (213) 223-7264
420 S Beverly Dr
Suite 100 9
Beverly Hills, CA 90212-4426
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY27239 | CA | MD | Clinical Psychologist |
| 27239 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mellow Medical Inc a Professional Corporation | Current | Accepting new patients | |
| Darrell Broaddus Psychological Services PC | Clinical | Past | Accepting new patients |
Locations
12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566
8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284
Interoperability endpoints
- https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4
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.
-
- Psychiatry Physician
- West Hollywood, CA
- NPI 1407275886
-
- Clinical Psychologist
- Orangevale, CA
- NPI 1215339650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744156800000",
"number": "1639308117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 S BEVERLY DR STE 100-9",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902124426",
"telephone_number": "213-223-7264",
"fax_number": "310-881-8628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 S BEVERLY DR STE 100-9",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902124426",
"telephone_number": "213-223-7264",
"fax_number": "310-881-8628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOURI",
"first_name": "NIMA",
"name_prefix": "Mr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-06",
"last_updated": "2025-04-09",
"certification_date": "2025-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY27239",
"primary": true
},
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.