Individual provider Active NPI

Andrea Rosen, PSY.D

  • Clinical Psychologist
  • Carson, CA
National Provider Identifier
1831229624
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28356 Issued in CA
Practice address
1 Civic Center Drive
Carson, CA 90745
Phone
(213) 605-4146
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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 PSY28356 CA Primary

Addresses

Primary practice location

1 Civic Center Drive
Carson, CA 90745

Mailing address

1 Civic Center Drive
Carson, CA 90745-4743
Phone (213) 605-4146

Other practice location 1

2790 Skypark Dr
Suite 210
Torrance, CA 90505-5300
Phone (310) 855-3990 ext. 4

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY28356CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Accent on Wellness Psychology Associates, Inc. Clinical 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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1831229624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CIVIC CENTER DRIVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907454743",
            "telephone_number": "213-605-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CIVIC CENTER DRIVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "90745",
            "telephone_number": "213-605-4146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2790 Skypark Dr",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905055300",
            "country_code": "US",
            "telephone_number": "310-855-3990 x4",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSEN",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.