Individual provider Active NPI

Katrin Malakuti, PSY.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1720337140
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26550 Issued in CA
Practice address
3580 Wilshire Blvd Ste 2000
Los Angeles, CA 90010-2533
Phone
(213) 381-1250
Fax
(213) 383-4803
NPI assigned
Aug 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY26550 CA Primary
Rehabilitation Counselor 225C00000X
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3580 Wilshire Blvd Ste 2000
Los Angeles, CA 90010-2533

Mailing address

9171 Wilshire Blvd Suite 660
Beverly Hills, CA 90210-3414
Phone (424) 645-7793

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26550CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1720337140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9171 WILSHIRE BLVD SUITE 660",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902103414",
            "telephone_number": "424-645-7793",
            "fax_number": "424-645-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 WILSHIRE BLVD STE 2000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102533",
            "telephone_number": "213-381-1250",
            "fax_number": "213-383-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAKUTI",
        "first_name": "KATRIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26550",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.