Individual provider Active NPI

Jacqueline W Lichtenstein, MD

  • Psychiatry Physician
  • Encino, CA
National Provider Identifier
1912085432
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G29548 Issued in CA
Practice address
16055 Ventura Blvd
# 710
Encino, CA 91436-2610
Phone
(818) 986-0404
Fax
(818) 905-8883
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

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
Psychiatry Physician 2084P0800X G29548 CA Primary

Addresses

Primary practice location

16055 Ventura Blvd
# 710
Encino, CA 91436-2610

Mailing address

16055 Ventura Blvd # 710
Encino, CA 91436-2610
Phone (818) 986-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019000266 CA Practitioner - PsychiatryPractitioner - Other (Physician) 6002009446 Practice locations: Encino, CA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
George Washington University School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16055 Ventura Blvd
Suite 1110
Encino, CA 91436-2612
Phone (818) 986-0404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G29548CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Claudia Eskenazi,PH.D.,M.F.T.,a.T.R.,Family Therapist, P.C. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912085432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD # 710",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362610",
            "telephone_number": "818-986-0404",
            "fax_number": "818-905-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD",
            "address_2": "# 710",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362610",
            "telephone_number": "818-986-0404",
            "fax_number": "818-905-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENSTEIN",
        "first_name": "JACQUELINE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G29548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.