Organization Active NPI

Karen E Dymond PHD Inc

  • Clinic/Center
  • La Habra, CA
National Provider Identifier
1952525602
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
KAREN E DYMOND PHD INC
Practice address
1480 S Harbor Blvd
Suite 14
La Habra, CA 90631-7534
Phone
(714) 447-8782
Fax
(714) 447-9386
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Authorized official

Name
Mr. Wayne Philip Lenz, MFT
Title
Cfo
Phone
(714) 447-8782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1480 S Harbor Blvd
Suite 14
La Habra, CA 90631-7534

Mailing address

1480 South Harbor Blvd
Suite 14
La Habra, CA 90631-7534
Phone (714) 447-8782

Other identifiers 1

IdentifierTypeStateIssuer
W16671OtherCAMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031120000988 CA Part B Supplier - Clinic/Group Practice 7810891942 Receives reassigned benefits from 1 practitioner
Practice locations: La Habra, CA

National Provider Directory

National Provider Directory

Locations

1480 S Harbor Blvd
Ste 15
La Habra, CA 90631
Phone (714) 447-8782

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517270400000",
    "number": "1952525602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 SOUTH HARBOR BLVD",
            "address_2": "SUITE 14",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906317534",
            "telephone_number": "714-447-8782",
            "fax_number": "714-447-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 S HARBOR BLVD",
            "address_2": "SUITE 14",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906317534",
            "telephone_number": "714-447-8782",
            "fax_number": "714-447-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN E DYMOND PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2018-01-30",
        "status": "A",
        "authorized_official_last_name": "LENZ",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "714-447-8782",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "W16671",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.