Individual provider Active NPI

Nyiema Desiree' Carter, PSYD

  • Clinical Psychologist
  • Carson, CA
National Provider Identifier
1699960021
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25623 Issued in CA
Practice address
335 E Albertoni St Ste 200-722
Carson, CA 90746-1425
Phone
(310) 738-9271
NPI assigned
Sep 10, 2007
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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 PSY25623 CA Primary

Addresses

Primary practice location

335 E Albertoni St Ste 200-722
Carson, CA 90746-1425

Mailing address

335 E Albertoni St Ste 200-722
Carson, CA 90746-1425
Phone (310) 738-9271

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
I20130621000421 CA Practitioner - Clinical Psychologist 2264671379 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
City2Village International Initiative Clinical CurrentSince Apr 6, 2021 Accepting new patients
Mendrix Medical Associates Inc Clinical CurrentSince Nov 15, 2024 Accepting new patients
Well2Thrive Psychological Consulting Clinical CurrentSince Jan 1, 2021 Accepting new patients

Locations

335 E Albertoni St
Ste 200722
Carson, CA 90746
Phone (310) 738-9271

18726 S Western Ave
Ste 320
Gardena, CA 90248
Phone (213) 373-3301

245 Cherry Ave
Long Beach, CA 90802
Phone (310) 773-8975

8601 Lincoln Blvd
Ste 108567
Los Angeles, CA 90045

1623 Arizona Ave
Santa Monica, CA 90404
Phone (213) 373-3301

Interoperability endpoints

  • Direct secure messaging: careleagueandpartnersdbacareleaguemedicalgroup.nyiemadcarter@158325.advancedmd-direct.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1699960021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 E ALBERTONI ST STE 200-722",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461425",
            "telephone_number": "310-738-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E ALBERTONI ST STE 200-722",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907461425",
            "telephone_number": "310-738-9271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "NYIEMA",
        "middle_name": "DESIREE'",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

Verify at the official NPI Registry.