Individual provider Active NPI

James Macdonald, PHD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1760237473
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY34898 Issued in CA
Practice address
11645 Wilshire Blvd Ste 1030
Los Angeles, CA 90025-6811
Phone
(310) 254-9748
NPI assigned
Apr 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 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 PSY34898 CA Primary

Addresses

Primary practice location

11645 Wilshire Blvd Ste 1030
Los Angeles, CA 90025-6811

Mailing address

11645 Wilshire Blvd Ste 1030
Los Angeles, CA 90025-6811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 18, 2024 through Sep 18, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY34898CAMDClinical Psychologist
34898CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1760237473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD STE 1030",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD STE 1030",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256811",
            "telephone_number": "310-254-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "JAMES",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY34898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.