Individual provider Active NPI

Roger Huang, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1942073002
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95037394 Issued in CA
Practice address
1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013
Phone
(424) 210-7724
NPI assigned
Nov 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95037394 CA Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X 95296380 CA
Psychiatric/Mental Health Registered Nurse 163WP0808X RN61393139 WA

Addresses

Primary practice location

1849 Sawtelle Blvd Ste 610
Los Angeles, CA 90025-7013

Mailing address

10736 Jefferson Blvd # 614
Culver City, CA 90230-4933
Phone (424) 210-7724

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260326003513 CA Practitioner - Nurse Practitioner 6608351747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10736 Jefferson Blvd
Suite 614
Culver City, CA 90230-4933

590 N Kimball Ave
Suite 100
Southlake, TX 76092-6878

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95296380CAMDPsychiatric/Mental Health Registered Nurse
RN61393139WAMDPsychiatric/Mental Health Registered Nurse
95037394CAMDPsychiatric/Mental Health Nurse Practitioner

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": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1942073002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10736 JEFFERSON BLVD # 614",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304933",
            "telephone_number": "424-210-7724",
            "fax_number": "800-493-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 SAWTELLE BLVD STE 610",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257013",
            "telephone_number": "424-210-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "ROGER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-01",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95037394",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95296380",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN61393139",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.