Active NPI
Karen E Dymond PHD Inc
- Clinic/Center
- La Habra, CA
National Provider Identifier
1952525602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W16671 | Other | CA | MEDICARE ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.