Individual provider Active NPI

Daniel A Kupper, PHD

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1699790907
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY14082 Issued in CA
Practice address
1917 1/2 Westwood Blvd
Ste 2
Los Angeles, CA 90025-8400
Phone
(310) 825-9989
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY14082 CA Primary

Addresses

Primary practice location

1917 1/2 Westwood Blvd
Ste 2
Los Angeles, CA 90025-8400

Mailing address

1917 1/2 Westwood Blvd
Ste 2
Los Angeles, CA 90025-8400
Phone (310) 441-5537

Other identifiers 1

IdentifierTypeStateIssuer
PSY140820MedicaidCA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060202000963 CA Practitioner - Clinical Psychologist 8224042825 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1917 /2 Westwood Blvd
Suite 2
Los Angeles, CA 90025-8400
Phone (310) 441-5537

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14082CAMDMental Health Counselor
PSY14082CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1699790907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 1/2 WESTWOOD BLVD",
            "address_2": "STE 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900258400",
            "telephone_number": "310-441-5537",
            "fax_number": "310-470-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 1/2 WESTWOOD BLVD",
            "address_2": "STE 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900258400",
            "telephone_number": "310-825-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPPER",
        "first_name": "DANIEL",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY14082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY140820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.