Individual provider Active NPI

Chari Joseph, PSYD

  • Clinical Psychologist
  • Los Angeles, CA
National Provider Identifier
1932656162
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31546 Issued in CA
Practice address
8601 Lincoln Blvd Ste 180-592
Los Angeles, CA 90045-3554
Phone
(424) 571-9508
NPI assigned
Sep 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X
Clinical Psychologist 103TC0700X PSY31546 CA Primary

Addresses

Primary practice location

8601 Lincoln Blvd Ste 180-592
Los Angeles, CA 90045-3554

Mailing address

8601 Lincoln Blvd Ste 180-592
Los Angeles, CA 90045-3554

Other names 1

  • Chari Bondurant Former 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
I20240214004024 CA Practitioner - Clinical Psychologist 7618311945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evolving Pathways Psychology CorporationGroup PAC ID 6002212115, 9 clinicians

Practice addresses (Care Compare)

2447 Pacific Coast Hwy
Suite 210
Hermosa Beach, CA 90254-2714
Phone (424) 212-3212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY31546CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Evolving Pathways Psychology Corporation Clinical CurrentSince Feb 1, 2024 Accepting new patients
Chari L Bondurant Psychologist a Professional Corporation CurrentSince Apr 6, 2023 Accepting new patients

Locations

2447 Pacific Coast Hwy
Ste 210
Hermosa Beach, CA 90254
Phone (310) 905-3151

2447 Pacific Coast Hwy
#210
Hermosa Beach, CA 90254
Phone (424) 212-3212

8601 Lincoln Blvd
Ste 180592
Los Angeles, CA 90045
Phone (424) 571-9508

473 E Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

473 S Carnegie Dr
Ste 200
Sn Bernrdno, CA 92408
Phone (562) 803-4500

Organizations & group practices 2

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": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1932656162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 LINCOLN BLVD STE 180-592",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 LINCOLN BLVD STE 180-592",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453554",
            "telephone_number": "424-571-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "CHARI",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARI",
            "last_name": "BONDURANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.