Active NPI
Alexandra Lee Mathews, PSYD
- Clinical Psychologist
- Canoga Park, CA
National Provider Identifier
1700043122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 17845
- Practice address
- 22048 Sherman Way
Suite 105
Canoga Park, CA 91303-3001 - Phone
- (818) 884-3075
- Fax
- (805) 496-1107
- NPI assigned
- May 22, 2008
- Last updated
- May 22, 2008
- 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 | PSY 17845 | CA | Primary |
Addresses
Primary practice location
22048 Sherman Way
Suite 105
Canoga Park, CA 91303-3001
Mailing address
22048 Sherman Way
Suite 105
Canoga Park, CA 91303-3001
Phone (818) 884-3075
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, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
9829 Blue Larkspur LN
Suite 2
Monterey, CA 93940-6535
Phone (831) 647-8490
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 17845 | CA | MD | Clinical Psychologist |
| 17845 | CA | MD | Marriage & Family Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Counseling Psychologist
- Monterey, CA
- NPI 1336680495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1700043122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22048 SHERMAN WAY",
"address_2": "SUITE 105",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913033001",
"telephone_number": "818-884-3075",
"fax_number": "805-496-1107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22048 SHERMAN WAY",
"address_2": "SUITE 105",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913033001",
"telephone_number": "818-884-3075",
"fax_number": "805-496-1107"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHEWS",
"first_name": "ALEXANDRA",
"middle_name": "LEE",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-05-22",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 17845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.