Individual provider Active NPI

Ralph G Diner, PH.D, M.S.C.P.

  • Clinical Psychologist
  • Encino, CA
National Provider Identifier
1801988431
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PC7457 Issued in CA
Practice address
16944 Ventura Blvd Ste 10
Encino, CA 91316-4161
Phone
(818) 231-2164
NPI assigned
Sep 29, 2006
Last updated
Mar 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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 PC7457 CA Primary

Addresses

Primary practice location

16944 Ventura Blvd Ste 10
Encino, CA 91316-4161

Mailing address

20541 Hiawatha St
Chatsworth, CA 91311-2413
Phone (818) 231-2164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091106000043 CA Practitioner - Psychologist Billing Independently 3971641267 Practice locations: Encino, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7457CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuro Psychology Assessment Center Inc PastSince Aug 9, 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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1801988431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20541 HIAWATHA ST",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913112413",
            "telephone_number": "818-231-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16944 VENTURA BLVD STE 10",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164161",
            "telephone_number": "818-231-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINER",
        "first_name": "RALPH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "PH.D, M.S.C.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PC7457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.