Dergregorian Psychological, Apc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DERGREGORIAN PSYCHOLOGICAL, APC

Practice address

231 E Burbank Blvd Apt 102
Burbank, CA 91502-1044

Phone

(626) 460-0327

NPI assigned

May 10, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Dergregorian, M.A. PSY.DNPI 1952650038

Title

Ceo

Phone

(714) 328-6307

Specialties & licenses 1

Addresses

Other names 1

• Porter Psychological, APC Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Abigail Dergregorian, PSY.D

  • Clinical Psychologist
  • Pasadena, CA
  • NPI 1952650038
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1922744101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 E BURBANK BLVD APT 102",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021044",
            "telephone_number": "626-460-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E BURBANK BLVD APT 102",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915021044",
            "telephone_number": "626-460-0327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERGREGORIAN PSYCHOLOGICAL, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-10",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "DERGREGORIAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-328-6307",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.A. PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porter Psychological, APC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Porter Psychological, APC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Psychologist in Burbank, CA
• Providers in Burbank, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.