Individual provider Active NPI

Ari David Kalechstein, PH.D

  • Clinical Neuropsychologist
  • Los Angeles, CA
National Provider Identifier
1851498737
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY14872 Issued in CA
Practice address
11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064
Phone
(310) 273-4843
Fax
(310) 273-5056
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY14872 CA Primary
Clinical Psychologist 103TC0700X 150137 AK
Clinical Neuropsychologist 103G00000X 150137 AK

Addresses

Primary practice location

11835 W Olympic Blvd Ste 1265E
Los Angeles, CA 90064

Mailing address

11835 W Olympic Blvd
Ste 1265E
Los Angeles, CA 90064-5814
Phone (310) 273-4843

Other identifiers 1

IdentifierTypeStateIssuer
546788MedicaidCA

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

LicenseStateTypeSpecialty
150137AKMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Wu MD PHD Inc CurrentSince Jul 1, 2021 Accepting new patients
Geriatric Care Associates Clinical Past Accepting new patients

Locations

11835 W Olympic Blvd
Ste 1270E
Los Angeles, CA 90064
Phone (310) 273-4843

16890 Green Tree Blvd
Victorville, CA 92395
Phone (310) 273-4843

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1851498737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD",
            "address_2": "STE 1265E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645814",
            "telephone_number": "310-273-4843",
            "fax_number": "310-273-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD STE 1265E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90064",
            "telephone_number": "310-273-4843",
            "fax_number": "310-273-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALECHSTEIN",
        "first_name": "ARI",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY14872",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AK",
            "license": "150137",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AK",
            "license": "150137",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "546788",
            "state": "CA"
        }
    ],
    "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 Nov 6, 2020; 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.