Individual provider Active NPI

Karen M. Derr, PH.D.

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1902992712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY13164 Issued in CA
Practice address
1516 Westwood Blvd.
Suite 104
Los Angeles, CA 90024-5616
Phone
(310) 337-1686
Fax
(310) 815-9254
NPI assigned
Oct 5, 2006
Sex
Female
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
Psychologist 103T00000X PSY13164 CA Primary

Addresses

Primary practice location

1516 Westwood Blvd.
Suite 104
Los Angeles, CA 90024-5616

Mailing address

1516 Westwood Blvd.
Suite 104
Los Angeles, CA 90024-5616
Phone (310) 337-1686

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

LicenseStateTypeSpecialty
PSY13164CAMDPsychologist
13164CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902992712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 WESTWOOD BLVD.",
            "address_2": "SUITE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245616",
            "telephone_number": "310-337-1686",
            "fax_number": "310-815-9254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 WESTWOOD BLVD.",
            "address_2": "SUITE 104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245616",
            "telephone_number": "310-337-1686",
            "fax_number": "310-815-9254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERR",
        "first_name": "KAREN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY13164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.