Active NPI
Randi Elisa Bienstock, PSY.D
- Intellectual & Developmental Disabilities Psychologist
- Los Angeles, CA
National Provider Identifier
1831394733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- PSY15925
- Practice address
- 9911 W Pico Blvd
Suite 1480
Los Angeles, CA 90035-2703 - Phone
- (310) 659-3823
- NPI assigned
- Jun 19, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | PSY15925 | CA | Primary |
Addresses
Primary practice location
9911 W Pico Blvd
Suite 1480
Los Angeles, CA 90035-2703
Mailing address
807 Prospect Ave
#202
South Pasadena, CA 91030-2457
Phone (310) 659-3823
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY159250 | Other | CA | MEDI-CAL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY15925 | CA | MD | Intellectual & Developmental Disabilities Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831394733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 PROSPECT AVE",
"address_2": "#202",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910302457",
"telephone_number": "310-659-3823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9911 W PICO BLVD",
"address_2": "SUITE 1480",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900352703",
"telephone_number": "310-659-3823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIENSTOCK",
"first_name": "RANDI",
"middle_name": "ELISA",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "CA",
"license": "PSY15925",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "PSY159250",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
- Joshua David Bienenfeld, MSW, LCSW
- Bienestar Human Services
- Bienestar Human Services
- Bienestar Human Services Inc
- Bienestar Human Services Inc
- Bienvenidos Children'S Center
- Bienvenidos Children'S Center
- Bienvenidos Children'S Center, Inc
- Bienvenidos Children'S Center, Inc
- Bienvenidos Children'S Center, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.