NPIMap

Organization Active NPI

Amen Clinics Inc, la

  • Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
  • Encino, CA
National Provider Identifier
1871119982
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianTaxonomy code 2084D0003X
Legal business name
AMEN CLINICS INC, LA
Practice address
5363 Balboa Blvd Ste 100
Encino, CA 91316-2802
Phone
(818) 479-4400
Fax
(818) 305-3779
NPI assigned
Jun 24, 2020
Organization subpart
Yes
Parent organization
AMEN CLINICS, INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Christina T McCormick, MS
Title
Data Systems Specialist
Phone
(703) 880-4000

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

National Provider Directory

National Provider Directory
Tax ID family
Amen Clinics Inc Walnut Creek11 organizations share this tax ID, including this one
Part of
Amen Clinics Inc Walnut Creek

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084D0003X Primary

Addresses

NPPES NPI Registry

Primary practice location

5363 Balboa Blvd Ste 100
Encino, CA 91316-2802

Mailing address

5363 Balboa Blvd Ste 100
Encino, CA 91316-2802
Phone (818) 479-4400

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 24, 2020.

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1871119982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD STE 100",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162802",
            "telephone_number": "818-479-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5363 BALBOA BLVD STE 100",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162802",
            "telephone_number": "818-479-4400",
            "fax_number": "818-305-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMEN CLINICS INC, LA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMEN CLINICS, INC",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DATA SYSTEMS SPECIALIST",
        "authorized_official_telephone_number": "703-880-4000",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "2084D0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.