Peter E Kolesnik, PSYD CLINICL PSYCHOL

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17933 Issued in CA

Practice address

5106 Via El Sereno
Torrance, CA 90505-6250

Phone

(310) 378-8870

Fax

(310) 378-0200

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Orange Community Care

  • Assisted Living Facility
  • Long Beach, CA
  • NPI 1407625700
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720208705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5106 VIA EL SERENO",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056250",
            "telephone_number": "310-378-8870",
            "fax_number": "310-378-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5106 VIA EL SERENO",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056250",
            "telephone_number": "310-378-8870",
            "fax_number": "310-378-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLESNIK",
        "first_name": "PETER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSYD CLINICL PSYCHOL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CP17933",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIF LICENSE",
            "identifier": "PSY17933",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert A Kolanz, MD
• Eva Kolasinski, D.M.D.
• Dyan Gale Kolb, LCSW
• Jennifer Kolb, MD
• Michelle Kole, PH.D.
• David Koller
• Catherine Teressa Kolo, MD
• Michael S. Kolodney, M.D.
• Thomas Kolokotrones, M.D., M.P.H., PH.D.
• Valerie Denise Kolone, PH.D.

• Clinical Psychologist in Torrance, CA
• Providers in Torrance, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.