NPIMap

Organization Active NPI

Wave Psychiatric Group, PC

  • Psychiatry Physician
  • Los Angeles, CA
National Provider Identifier
1962981183
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WAVE PSYCHIATRIC GROUP, PC
Practice address
11835 W Olympic Blvd Ste 1040E
Los Angeles, CA 90064-5806
Phone
(323) 688-6380
NPI assigned
Aug 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Authorized official

Name
Dr. Brandon D. Schneider, MDNPI 1760802920
Title
Coo, Secretary
Phone
(323) 688-6380

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

11835 W Olympic Blvd Ste 1040E
Los Angeles, CA 90064-5806

Mailing address

11835 W Olympic Blvd Ste 1040E
Los Angeles, CA 90064-5806
Phone (323) 688-6380

National Provider Directory

National Provider Directory

Locations

11835 W Olympic Blvd
Ste 1040E
Los Angeles, CA 90064
Phone (323) 688-6380

Practitioners & affiliated clinicians

Practitioners 4

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": "1533686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567555200000",
    "number": "1962981183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD STE 1040E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645806",
            "telephone_number": "323-688-6380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD STE 1040E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645806",
            "telephone_number": "323-688-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVE PSYCHIATRIC GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-08",
        "last_updated": "2019-09-04",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "COO, SECRETARY",
        "authorized_official_telephone_number": "323-688-6380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.