Susan Bakota, ED.D.

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

PSY13135 Issued in CA

Practice address

9300 Wilshire Blvd
Beverly Hills, CA 90212-3213

Phone

(310) 478-7733

NPI assigned

Apr 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 24, 2018 through Apr 24, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1861615924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 WILSHIRE BLVD STE 320",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123203",
            "telephone_number": "310-478-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 WILSHIRE BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123213",
            "telephone_number": "310-478-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKOTA",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "CA",
            "license": "PSY13135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oded Bahat, BDS MSD
• Donna Bahroloomi, MD/MPH
• Joseph Brady Bailey, M.D., M.B.A.
• Marni Paige Baim, LCSW
• Susan A. Baker, M.D.
• Haleh Bakshandeh, MD
• Kiumars Bakshandeh, M.D.
• Bal M Rajagopalan MD Inc a Medical Corp
• Madison Ryan Balachio, PA
• Hilda Balakhane, LCSW

• Prescribing (Medical) Psychologist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Prescribing (Medical) Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.