Active NPI
Sandra Sue Kagan, PH.D.
- Counselor
- Valley Village, CA
National Provider Identifier
1982775532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- MFT067730
- Practice address
- 4821 Beeman Ave
Valley Village, CA 91607-3402 - Phone
- (818) 789-7575
- Fax
- (818) 761-4449
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | MFT067730 | CA | Primary |
Addresses
Primary practice location
4821 Beeman Ave
Valley Village, CA 91607-3402
Mailing address
12400 Ventura Blvd
641
Studio City, CA 91604-2406
Phone (818) 789-7575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT067730 | CA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982775532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12400 VENTURA BLVD",
"address_2": "641",
"city": "STUDIO CITY",
"state": "CA",
"postal_code": "916042406",
"telephone_number": "818-789-7575",
"fax_number": "818-761-4449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4821 BEEMAN AVE",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916073402",
"telephone_number": "818-789-7575",
"fax_number": "818-761-4449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAGAN",
"first_name": "SANDRA",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": "MFT067730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Village, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.