Individual provider Active NPI

Leah L. Dickenson, PH.D.

  • Clinical Psychologist
  • Westlake Village, CA
National Provider Identifier
1740429547
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31824 Issued in CA
Practice address
2660 Townsgate Rd Ste 530
Westlake Village, CA 91361
Phone
(805) 217-3914
NPI assigned
Feb 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY31824 CA Primary
Clinical Child & Adolescent Psychologist 103TC2200X

Addresses

Primary practice location

2660 Townsgate Rd Ste 530
Westlake Village, CA 91361

Mailing address

820 Calle Fresno
Thousand Oaks, CA 91360-4656
Phone (805) 217-3914

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
I20200623001370 CA Practitioner - Clinical Psychologist 3971925868 Practice locations: Westlake Village, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2660 Townsgate Rd
Suite 530
Westlake Village, CA 91361-5711
Phone (805) 217-3914

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY31824CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1740429547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 CALLE FRESNO",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604656",
            "telephone_number": "805-217-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 TOWNSGATE RD STE 530",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "91361",
            "telephone_number": "805-217-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENSON",
        "first_name": "LEAH",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31824",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

Verify at the official NPI Registry.