NPIMap

Organization Active NPI

Pacific Forensic Psychology Associates, Inc

  • Forensic Psychologist
  • Los Angeles, CA
National Provider Identifier
1992997597
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
Legal business name
PACIFIC FORENSIC PSYCHOLOGY ASSOCIATES, INC
Practice address
616 Shatto PL
Los Angeles, CA 90005-1301
Phone
(213) 738-8853
Fax
(213) 738-5368
NPI assigned
Aug 16, 2007
Organization subpart
Yes
Parent organization
PACIFIC FORENSIC PSYCHOLOGY ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
Dr. Lea Chankin, PSY.D.
Title
Director
Phone
(213) 738-8853

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X
Cognitive & Behavioral PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TB0200X
Forensic PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0200X CA Primary

Addresses

Primary practice location

616 Shatto PL
Los Angeles, CA 90005-1301

Mailing address

616 Shatto PL
Los Angeles, CA 90005-1301
Phone (213) 738-8853

Other names 1

  • Sharp Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pacific Forensic Psychology Associates Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

616 Shatto Pl
Los Angeles, CA 90005
Phone (213) 738-8853

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1992997597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 SHATTO PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051301",
            "telephone_number": "213-738-8853",
            "fax_number": "213-738-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 SHATTO PL",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051301",
            "telephone_number": "213-738-8853",
            "fax_number": "213-738-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC FORENSIC PSYCHOLOGY ASSOCIATES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PACIFIC FORENSIC PSYCHOLOGY ASSOCIATES, INC",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "CHANKIN",
        "authorized_official_first_name": "LEA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "213-738-8853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharp Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 16, 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.