Individual provider Active NPI

Martin Victor Cohen, PH.D.

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1861605149
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 21166 Issued in CA
Practice address
2001 S Barrington Ave
Suite 307
Los Angeles, CA 90025-5363
Phone
(310) 478-5888
Fax
(310) 478-1101
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PSY 21166 CA Primary

Addresses

Primary practice location

2001 S Barrington Ave
Suite 307
Los Angeles, CA 90025-5363

Mailing address

2001 S Barrington Ave
Suite 307
Los Angeles, CA 90025-5363
Phone (310) 478-5888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070830000515 CA Practitioner - Clinical Psychologist 7517050933 Practice locations: Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2001 S Barrington Ave
Suite 307
Los Angeles, CA 90025-5379
Phone (310) 478-5888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 21166CAMDClinical Psychologist
21166CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861605149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE",
            "address_2": "SUITE 307",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255363",
            "telephone_number": "310-478-5888",
            "fax_number": "310-478-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S BARRINGTON AVE",
            "address_2": "SUITE 307",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900255363",
            "telephone_number": "310-478-5888",
            "fax_number": "310-478-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MARTIN",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 21166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.