Active NPI
D Louise Mebane, PHD
- Clinical Psychologist
- Beverly Hills, CA
National Provider Identifier
1902834252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY12373
- Practice address
- 153 So Lasky Dr
#8
Beverly Hills, CA 90212 - Phone
- (310) 262-2033
- Fax
- (323) 933-5769
- NPI assigned
- Jun 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY12373 | CA | Primary |
| Psychologist | 103T00000X | PSY12373 | CA |
Addresses
Primary practice location
153 So Lasky Dr
#8
Beverly Hills, CA 90212
Mailing address
1628 Ellsmere Ave
Los Angeles, CA 90019
Phone (310) 262-2033
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY123732 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY12373 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236211200000",
"number": "1902834252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1628 ELLSMERE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90019",
"telephone_number": "310-262-2033",
"fax_number": "323-933-5769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 SO LASKY DR",
"address_2": "#8",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "90212",
"telephone_number": "310-262-2033",
"fax_number": "323-933-5769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEBANE",
"first_name": "D",
"middle_name": "LOUISE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-28",
"last_updated": "2009-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY12373",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY12373",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY123732",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.