Active NPI
Elizabeth Reyes, PHD
- Psychologist
- Los Angeles, CA
National Provider Identifier
1821476664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY20655
- Practice address
- 10801 National Blvd Ste 253
Los Angeles, CA 90064-4178 - Phone
- (310) 889-8215
- Fax
- (310) 496-6757
- NPI assigned
- May 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY20655 | CA | |
| Counseling Psychologist | 103TC1900X | PSY20655 | CA | |
| Psychologist | 103T00000X | PSY20655 | CA | Primary |
Addresses
Primary practice location
10801 National Blvd Ste 253
Los Angeles, CA 90064-4178
Mailing address
10801 National Blvd Ste 253
Los Angeles, CA 90064-4178
Phone (310) 889-8215
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY20655 | CA | MD | Counseling Psychologist |
| 20655 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elizabeth a. Reyes, PH.D. | Counseling | Past | 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 and National Provider Directory roles.
-
- Counseling Psychologist
- Los Angeles, CA
- NPI 1922283233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719360000000",
"number": "1821476664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10801 NATIONAL BLVD STE 253",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900644178",
"telephone_number": "310-889-8215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10801 NATIONAL BLVD STE 253",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900644178",
"telephone_number": "310-889-8215",
"fax_number": "310-496-6757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "ELIZABETH",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-13",
"last_updated": "2024-06-26",
"certification_date": "2024-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY20655",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY20655",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY20655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.