Brandie Boghosian, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

30570 Issued in CA

Practice address

30200 Agoura Rd Ste 190
Agoura, CA 91301

Phone

(818) 624-3062

NPI assigned

Jun 9, 2014

Last updated

Apr 1, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jaime Elizabeth Medvene PHD a Professional Psychological CorporaGroup PAC ID 7911063201, 9 clinicians

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jaime Elizabeth Medvene PHD a Professional Psychological Corpora

  • Clinical Psychologist
  • Agoura Hills, CA
  • NPI 1306084272
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1821401787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4973",
            "city": "WEST HILLS",
            "state": "CA",
            "postal_code": "913084973",
            "telephone_number": "818-624-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30200 AGOURA RD STE 190",
            "city": "AGOURA",
            "state": "CA",
            "postal_code": "91301",
            "telephone_number": "818-624-3062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18646 Oxnard St",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913561411",
            "country_code": "US",
            "telephone_number": "818-624-3062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5743 Corsa Ave Ste 112",
            "address_purpose": "LOCATION",
            "city": "Westlake Village",
            "state": "CA",
            "postal_code": "913626441",
            "country_code": "US",
            "telephone_number": "818-624-3062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGHOSIAN",
        "first_name": "BRANDIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicolle Alex, MFT
• Kirby Suzzanne Brock
• Faye Evelyn Brownfield, MD
• C2C Diagnostics, LLC
• Josh Cherin
• Core Medical

• Clinical Psychologist in Agoura, CA
• Providers in Agoura, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.