Individual provider Active NPI

Leslie Ann Eichenbaum, PH.D.

  • Psychologist
  • Encino, CA
National Provider Identifier
1740333988
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY7579 Issued in CA
Practice address
3501 Terrace View Dr
Encino, CA 91436-4017
Phone
(818) 789-7443
Fax
(818) 789-7558
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY7579 CA Primary

Addresses

Primary practice location

3501 Terrace View Dr
Encino, CA 91436-4017

Mailing address

3501 Terrace View Dr
Encino, CA 91436-4017
Phone (818) 789-7443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 6, 2017 through Jan 6, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7579CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1740333988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 TERRACE VIEW DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364017",
            "telephone_number": "818-789-7443",
            "fax_number": "818-789-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 TERRACE VIEW DR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364017",
            "telephone_number": "818-789-7443",
            "fax_number": "818-789-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHENBAUM",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY7579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.