Active NPI
Charlie Champion
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1679128003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32978
- Practice address
- 221 Westwood PLZ
Los Angeles, CA 90095-8508 - Phone
- (209) 380-4952
- NPI assigned
- Aug 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 32978 | CA | Primary |
Addresses
Primary practice location
221 Westwood PLZ
Los Angeles, CA 90095-8508
Mailing address
8710 Belford Ave Apt 226
Los Angeles, CA 90045-4575
Phone (209) 380-4952
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32978 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Octave Behavioral Health PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- San Francisco, CA
- NPI 1184199549
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735430400000",
"number": "1679128003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8710 BELFORD AVE APT 226",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900454575",
"telephone_number": "209-380-4952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 WESTWOOD PLZ",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958508",
"telephone_number": "209-380-4952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMPION",
"first_name": "CHARLIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-02",
"last_updated": "2024-12-29",
"certification_date": "2024-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
- Kim Teri Champagne, RCP
- Philip Champagne
- Philippe Champagne, M.D.
- Champion Medical Group (Universal Psychiatric Center)
- Champion Medical Group, a Medical Corporation
- Shanece Marie Champion
- Patricia Elizabeth Chamul, PHYSICIAN ASSISTANT
- Chan and Kimn Medical Group
- Melanie Del Carmen Chan Cowes, MD
- Chan Family Medical Corp (Shiny Star Medical Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.