Individual provider Active NPI

Daisy Obetsanov, PH.D.

  • Clinical Psychologist
  • Long Beach, CA
National Provider Identifier
1982789947
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31418 Issued in CA
Practice address
PO Box 7683
Long Beach, CA 90807-0683
Phone
(103) 217-7312
NPI assigned
Oct 26, 2006
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY31418 CA Primary
Clinical Social Worker 1041C0700X LCS23381 CA

Addresses

Primary practice location

PO Box 7683
Long Beach, CA 90807-0683

Mailing address

PO Box 7683
Long Beach, CA 90807-0683
Phone (310) 217-7312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230614003721 CA Practitioner - Clinical Psychologist 9032577515 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

529 Maple Ave
Los Angeles, CA 90013-1511
Phone (213) 629-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY31418CAMDClinical Psychologist
LCS23381CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Apr 16, 2023 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Grow Healthcare Group PC Clinical CurrentSince Nov 21, 2025 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Apr 16, 2023 Accepting new patients
Sud Specialty Group - Ca Clinical CurrentSince Jan 1, 2026 Accepting new patients

Locations

14112 S Kingsley Dr
Gardena, CA 90249
Phone (310) 217-7312

1720 E 120th St
#6
Los Angeles, CA 90059

1816 S Figueroa St
Fl 6
Los Angeles, CA 90015
Phone (213) 763-0300

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

529 Maple Ave
Los Angeles, CA 90013
Phone (213) 430-6700

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (323) 745-8323

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1982789947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7683",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908070683",
            "telephone_number": "310-217-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 7683",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908070683",
            "telephone_number": "103-217-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBETSANOV",
        "first_name": "DAISY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31418",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.