Individual provider Active NPI

Ahuva Braverman, PH.D.

  • Clinical Psychologist
  • Santa Monica, CA
National Provider Identifier
1750479317
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 12873 Issued in CA
Practice address
1137 2ND St Ste 109
Santa Monica, CA 90403-5061
Phone
(310) 535-7014
Fax
(310) 829-2454
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY 12873 CA Primary

Addresses

Primary practice location

1137 2ND St Ste 109
Santa Monica, CA 90403-5061

Mailing address

2910 Montana Ave
Santa Monica, CA 90403-2216
Phone (310) 535-7014

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
I20180312001108 CA Practitioner - Clinical Psychologist 9133480023 Practice locations: Santa Monica, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 12873CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Psychologist, Inc. Clinical PastSince Mar 13, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750479317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 MONTANA AVE",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032216",
            "telephone_number": "310-535-7014",
            "fax_number": "310-829-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 2ND ST STE 109",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035061",
            "telephone_number": "310-535-7014",
            "fax_number": "310-829-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVERMAN",
        "first_name": "AHUVA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 12873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.