Individual provider Active NPI

Aleyne Danielle Eatman, PSY.D.

  • Psychologist
  • Culver City, CA
National Provider Identifier
1851548226
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY24671 Issued in CA
Practice address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone
(661) 231-0390
Fax
(310) 398-5690
NPI assigned
Aug 27, 2008
Last updated
Jun 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Psychologist 103T00000X 3135 TN
Psychologist 103T00000X PSY24671 CA Primary
Rehabilitation Counselor 225C00000X

Addresses

Primary practice location

4760 Sepulveda Blvd
Culver City, CA 90230-4820

Mailing address

1540 E Colorado St
Glendale, CA 91205-1514
Phone (818) 244-7257

Other practice location 1

482 N Rosemead Blvd
Ste 103
Pasadena, CA 91107-3001
Phone (901) 372-9133

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

State licenses

LicenseStateTypeSpecialty
PSY24671CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Randy Christopher 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.

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1851548226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051514",
            "telephone_number": "818-244-7257",
            "fax_number": "818-243-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "661-231-0390",
            "fax_number": "310-398-5690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "482 N ROSEMEAD BLVD",
            "address_2": "STE 103",
            "address_purpose": "LOCATION",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073001",
            "country_code": "US",
            "telephone_number": "901-372-9133",
            "fax_number": "901-372-1015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EATMAN",
        "first_name": "ALEYNE",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "3135",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY24671",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.