Individual provider Active NPI

Melissa L. Randall, PH.D.

  • Clinical Psychologist
  • Sherman Oaks, CA
National Provider Identifier
1932284486
Registry record updated Jun 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY16375 Issued in CA
Practice address
15300 Ventura Blvd Ste 410
Sherman Oaks, CA 91403-5849
Phone
(818) 399-9069
Fax
(818) 986-0496
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY16375 CA Primary

Addresses

Primary practice location

15300 Ventura Blvd Ste 410
Sherman Oaks, CA 91403-5849

Mailing address

PO Box 56355
Sherman Oaks, CA 91413-1355
Phone (818) 399-9069

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
I20120327000848 CA Practitioner - Clinical Psychologist 1951561034 Practice locations: Sherman Oaks, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15300 Ventura Blvd
Suite 410
Sherman Oaks, CA 91403-5849
Phone (818) 399-9069

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560556800000",
    "number": "1932284486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56355",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914131355",
            "telephone_number": "818-399-9069",
            "fax_number": "818-986-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 VENTURA BLVD STE 410",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035849",
            "telephone_number": "818-399-9069",
            "fax_number": "818-986-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "MELISSA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2019-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.