Individual provider Active NPI

Katie Troxell, PHD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1730940586
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34804 Issued in CA
Practice address
10953 Massachusetts Ave
Los Angeles, CA 90024-5519
Phone
(714) 914-6576
NPI assigned
Jan 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY34804 CA Primary

Addresses

Primary practice location

10953 Massachusetts Ave
Los Angeles, CA 90024-5519

Mailing address

10953 Massachusetts Ave
Los Angeles, CA 90024-5519
Phone (714) 914-6576

Other names 1

  • Katie Van Moorleghem Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240820001915 CA Practitioner - Clinical Psychologist 4880132919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Neurology Medical Group, Inc.Group PAC ID 5294997854, 10 clinicians

Practice addresses (Care Compare)

625 S Fair Oaks Ave
Suite 325
Pasadena, CA 91105-2675
Phone (626) 535-9344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY34804CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Neurology Medical Group, Inc. CurrentSince Aug 12, 2024 Accepting new patients
Southern California Neurology Medical Group, Inc. CurrentSince Aug 12, 2024 Accepting new patients

Locations

625 S Fair Oaks Ave
Ste 325
Pasadena, CA 91105
Phone (626) 229-8969

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1730940586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10953 MASSACHUSETTS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245519",
            "telephone_number": "714-914-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10953 MASSACHUSETTS AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245519",
            "telephone_number": "714-914-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROXELL",
        "first_name": "KATIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "VAN MOORLEGHEM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.