Active NPI
Luis Jaime Fitten, M.D.
- Geriatric Psychiatry Physician
- North Hills, CA
National Provider Identifier
1790855146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- A29609
- Practice address
- 16111 Plummer St
North Hills, CA 91343-2036 - Phone
- (818) 895-9349
- Fax
- (818) 895-9515
- NPI assigned
- Nov 9, 2006
- Last updated
- Apr 16, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | A29609 | CA | Primary |
Addresses
Primary practice location
16111 Plummer St
North Hills, CA 91343-2036
Mailing address
16111 Plummer St
North Hills, CA 91343-2036
Phone (818) 895-9349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 3, 2017 through Jan 3, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29609 | CA | MD | Psychologist |
| A29609 | CA | MD | Geriatric Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Coast Psychiatric Associates Inc | Past | Accepting new patients |
Interoperability endpoints
- lifestancehealth.luisfitten@148377.advancedmd-direct.com
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.
-
dba Lifestance Health
- Clinical Psychologist
- Scottsdale, AZ
- NPI 1023125465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523836800000",
"number": "1790855146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16111 PLUMMER ST",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913432036",
"telephone_number": "818-895-9349",
"fax_number": "818-895-9515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16111 PLUMMER ST",
"city": "NORTH HILLS",
"state": "CA",
"postal_code": "913432036",
"telephone_number": "818-895-9349",
"fax_number": "818-895-9515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITTEN",
"first_name": "LUIS",
"middle_name": "JAIME",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2018-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "CA",
"license": "A29609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.