Active NPI
Paul Perales, PSYD
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1720627052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 31570
- Practice address
- 947 N la Cienega Blvd Ste H
Los Angeles, CA 90069-4700 - Phone
- (310) 962-0588
- NPI assigned
- Jan 3, 2020
- Sex
- Male
- 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 | 31570 | CA | Primary |
Addresses
Primary practice location
947 N la Cienega Blvd Ste H
Los Angeles, CA 90069-4700
Mailing address
833 N Edinburgh Ave Unit 202
Los Angeles, CA 90046-6947
Phone (310) 962-0588
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31570 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578009600000",
"number": "1720627052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 N EDINBURGH AVE UNIT 202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900466947",
"telephone_number": "310-962-0588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "947 N LA CIENEGA BLVD STE H",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900694700",
"telephone_number": "310-962-0588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERALES",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-01-03",
"last_updated": "2020-01-03",
"certification_date": "2020-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "31570",
"primary": true
}
],
"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 Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.