Individual provider Active NPI

Dyan Haspel-Johnson, PH.D.

  • Clinical Psychologist
  • Santa Monica, CA
National Provider Identifier
1821390345
Registry record updated May 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY22913 Issued in CA
Practice address
610 Santa Monica Blvd
Suite 216
Santa Monica, CA 90401-1632
Phone
(310) 482-7917
Fax
(310) 496-0308
NPI assigned
Dec 3, 2010
Last updated
May 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2014

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 PSY22913 CA Primary

Addresses

Primary practice location

610 Santa Monica Blvd
Suite 216
Santa Monica, CA 90401-1632

Mailing address

610 Santa Monica Blvd
Suite 216
Santa Monica, CA 90401-1632
Phone (310) 482-7917

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Dec 31, 2012 through Dec 31, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY22913CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400371200000",
    "number": "1821390345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SANTA MONICA BLVD",
            "address_2": "SUITE 216",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011632",
            "telephone_number": "310-482-7917",
            "fax_number": "310-496-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SANTA MONICA BLVD",
            "address_2": "SUITE 216",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011632",
            "telephone_number": "310-482-7917",
            "fax_number": "310-496-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASPEL-JOHNSON",
        "first_name": "DYAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2014-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.