Samantha Kucaj

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY30599 Issued in CA

Practice address

300 UCLA Medical PLZ Ste 3300
Los Angeles, CA 90095-6062

Phone

(323) 825-0867

Fax

(310) 206-4215

NPI assigned

Sep 9, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• UC Regents

  • Pediatrics Physician
  • Los Angeles, CA
  • NPI 1982667663
  Medicare reassignment NPD

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1811444599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8807",
            "fax_number": "310-301-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 UCLA MEDICAL PLZ STE 3300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900956062",
            "telephone_number": "323-825-0867",
            "fax_number": "310-206-4215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCAJ",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY30599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Jo Kubiak, LMFT
• Alisa Kublanovsky
• Nasma Kublawi
• Scott Steven Kubota, DDS
• Diane Lee Kubrin, MFT
• Kenneth Frank Kuchta, MD
• Hrant Kuchuryan, PT
• Margaret Virginia Kudlinski
• Kudos Mental Health LLC
• Joanna Kuehl, NNP

• Clinical Child & Adolescent Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.