Active NPI
Andrea Dillon, PSY.D.
- Clinical Neuropsychologist
- Los Angeles, CA
National Provider Identifier
1780969683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PSY 24173
- Practice address
- 11340 W Olympic Blvd
Ste 250
Los Angeles, CA 90064-1608 - Phone
- (949) 484-8565
- NPI assigned
- Oct 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PSY 24173 | CA | Primary |
| Psychologist | 103T00000X | PSY 24173 | CA |
Addresses
Primary practice location
11340 W Olympic Blvd
Ste 250
Los Angeles, CA 90064-1608
Mailing address
149 S Barrington Ave
Ste. 116
Los Angeles, CA 90049-3310
Phone (949) 484-8565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 24173 | CA | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318377600000",
"number": "1780969683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 S BARRINGTON AVE",
"address_2": "STE. 116",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900493310",
"telephone_number": "949-484-8565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11340 W OLYMPIC BLVD",
"address_2": "STE 250",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900641608",
"telephone_number": "949-484-8565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLON",
"first_name": "ANDREA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-12",
"last_updated": "2011-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CA",
"license": "PSY 24173",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY 24173",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.