Catherine A Deridder, MD

Primary specialty

Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X

License

A111949 Issued in CA

Practice address

1000 W Carson St # 437
Harbor-UCLA Medical Center
Torrance, CA 90502-2004

Phone

(310) 222-2199

Fax

(310) 533-8579

NPI assigned

Jun 19, 2007

Last updated

May 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Catherine M Adrian Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Pico Rivera, CA
  • NPI 1891287827
  NPD

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1780889691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST # 437",
            "address_2": "HARBOR-UCLA MEDICAL CENTER",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST # 437",
            "address_2": "HARBOR-UCLA MEDICAL CENTER",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-2199",
            "fax_number": "310-533-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERIDDER",
        "first_name": "CATHERINE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "CA",
            "license": "A111949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4733 W Sunset Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900276021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "ADRIAN",
            "middle_name": "M",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cara L.. Depamphilis
• Deparement of Mantal Health
• Department of Mental Health
• Department of Mental Health (Harbor UCLA)
• Myra Rashmi Deperalta, MD
• Amrita Desai, P.A.-C
• Ayushi Desai, M.D.
• Prakash Desai, D.O.
• Sushila Desai, LCSW
• Leila Deschuytter, OTR/L

• Pediatrics Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.