MEDICARE: KAREN LEVINE PHD PSYCHOLOGY PROFESSIONAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1396603031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAREN LEVINE PHD PSYCHOLOGY PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	428 GRAND AVE
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-1635
Country	:	US
Telephone Number	:	213-924-5003
Fax Number	:

Provider Business Practice Location Address
First Line	:	428 GRAND AVE
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-1635
Country	:	US
Telephone Number	:	213-924-5003
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICAL PSYCHOLOGIST
Name	:	DR. KAREN LEVINE
Credential	:	PH.D.
Telephone Number	:	213-924-5003

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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