Individual provider Active NPI

Jodi S. Larman

  • Clinical Psychologist
  • Simi Valley, CA
National Provider Identifier
1972532802
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY20301 Issued in CA
Practice address
2650 Jones Way Ste 10
Simi Valley, CA 93065-1215
Phone
(805) 522-1844
Fax
(805) 522-5345
NPI assigned
Jul 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY20301 CA Primary

Addresses

Primary practice location

2650 Jones Way Ste 10
Simi Valley, CA 93065-1215

Mailing address

PO Box 8014
Northridge, CA 91327-8014
Phone (818) 516-5689

Other identifiers 1

IdentifierTypeStateIssuer
PSY203010MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972532802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8014",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913278014",
            "telephone_number": "818-516-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 JONES WAY STE 10",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651215",
            "telephone_number": "805-522-1844",
            "fax_number": "805-522-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARMAN",
        "first_name": "JODI",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSY203010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.