Carnelian Psychological and Educational Group, Inc

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Legal business name

CARNELIAN PSYCHOLOGICAL AND EDUCATIONAL GROUP, INC

Practice address

12522 Moorpark St # 108
Studio City, CA 91604-1355

Phone

(818) 666-9434

NPI assigned

May 5, 2022

Organization subpart

No

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

Authorized official

Name

Lyre Fribourg, PHDNPI 1609121201

Title

Owner

Phone

(818) 666-9434

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lyre Caruz Fribourg, PH.D, BCBA-D

  • Clinical Psychologist
  • Studio City, CA
  • NPI 1609121201

  Behavior Analyst

  NPD Authorized official

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1720724446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12522 MOORPARK ST # 107",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916041355",
            "telephone_number": "818-666-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12522 MOORPARK ST # 108",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916041355",
            "telephone_number": "818-666-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARNELIAN PSYCHOLOGICAL AND EDUCATIONAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "FRIBOURG",
        "authorized_official_first_name": "LYRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-666-9434",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Psychologist in Studio City, CA
• Providers in Studio City, CA by specialty
• School Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.