Individual provider Active NPI

Antoinette Marie Kathol Ibrahimi, PSY.D.

  • Clinical Psychologist
  • Claremont, CA
National Provider Identifier
1871720813
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY27466 Issued in CA
Practice address
411 N Indian Hill Blvd
Claremont, CA 91711-4614
Phone
(626) 470-7792
NPI assigned
Jun 17, 2009
Last updated
Oct 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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 PSY27466 CA Primary

Addresses

Primary practice location

411 N Indian Hill Blvd
Claremont, CA 91711-4614

Mailing address

PO Box 5501
Pasadena, CA 91117-0501
Phone (626) 818-8327

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
PSY27466CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Leaf Counseling, Inc. Mental Health CurrentSince Apr 28, 2024 Accepting new patients

Locations

411 N Indian Hill Blvd
Claremont, CA 91711
Phone (626) 214-8384

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1871720813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5501",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911170501",
            "telephone_number": "626-818-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N INDIAN HILL BLVD",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114614",
            "telephone_number": "626-470-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIMI",
        "first_name": "ANTOINETTE",
        "middle_name": "MARIE KATHOL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.