Individual provider Active NPI

Haleh Homayounjam, PSY.D.

  • Psychologist
  • Beverly Hills, CA
National Provider Identifier
1922122589
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY16744 Issued in CA
Practice address
499 N Canon Dr
Ste 407
Beverly Hills, CA 90210-4887
Phone
(310) 614-0760
NPI assigned
Mar 19, 2007
Last updated
Jan 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY16744 CA Primary

Addresses

Primary practice location

499 N Canon Dr
Ste 407
Beverly Hills, CA 90210-4887

Mailing address

314 12TH St
Ms 115 Mental Health Services Childrens Hospital
Santa Monica, CA 90402-2014
Phone (310) 614-0760

Other names 1

  • Dr. Haleh Stahl Other name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120423000448 CA Practitioner - Clinical Psychologist 1557522323 Practice locations: Beverly Hills, CA; Los Angeles, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

499 N Canon Dr
Suite 407
Beverly Hills, CA 90210-4887
Phone (310) 614-0760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY16744CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1922122589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 12TH ST",
            "address_2": "MS 115 MENTAL HEALTH SERVICES CHILDRENS HOSPITAL",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022014",
            "telephone_number": "310-614-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 N CANON DR",
            "address_2": "STE 407",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104887",
            "telephone_number": "310-614-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMAYOUNJAM",
        "first_name": "HALEH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY16744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEH",
            "last_name": "STAHL",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Beverly Hills, CA

Sources for this page

Verify at the official NPI Registry.