Individual provider Active NPI

Kameron Beckett

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1861168197
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY36105 Issued in CA
Practice address
11270 Exposition Blvd Unit 64224
Los Angeles, CA 90064-5904
Phone
(909) 642-5540
NPI assigned
Aug 17, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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 PSY36105 CA Primary

Addresses

Primary practice location

11270 Exposition Blvd Unit 64224
Los Angeles, CA 90064-5904

Mailing address

11270 Exposition Blvd Unit 64224
Los Angeles, CA 90064-5904
Phone (323) 431-9747

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
PSY36105CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Minds Psychology Inc Clinical CurrentSince Sep 1, 2025 Accepting new patients
New Fresh Start LLC Clinical CurrentSince Sep 1, 2025 Accepting new patients

Locations

11270 Exposition Blvd
Unit 64224
Los Angeles, CA 90064
Phone (323) 431-9747

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768780800000",
    "number": "1861168197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11270 EXPOSITION BLVD UNIT 64224",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645904",
            "telephone_number": "323-431-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11270 EXPOSITION BLVD UNIT 64224",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645904",
            "telephone_number": "909-642-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKETT",
        "first_name": "KAMERON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY36105",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 19, 2026; 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.