Active NPI
Charles E Hanson, PH.D.
- Clinical Psychologist
- Northridge, CA
National Provider Identifier
1851443295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY8639
- Practice address
- 9003 Reseda Blvd
208
Northridge, CA 91324-3920 - Phone
- (818) 772-0177
- Fax
- (310) 455-4023
- NPI assigned
- Jan 17, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY8639 | CA | Primary |
Addresses
Primary practice location
9003 Reseda Blvd
208
Northridge, CA 91324-3920
Mailing address
9003 Reseda Blvd
208
Northridge, CA 91324-3920
Phone (818) 772-0177
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY8639 | CA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado River Home Health | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Needles, CA
- NPI 1891273181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851443295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9003 RESEDA BLVD",
"address_2": "208",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913243920",
"telephone_number": "818-772-0177",
"fax_number": "310-455-4023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9003 RESEDA BLVD",
"address_2": "208",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913243920",
"telephone_number": "818-772-0177",
"fax_number": "310-455-4023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "CHARLES",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY8639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
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.