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Physician Compare National (NPI:1932284486)

HEALTHCARE PROVIDER: MELISSA L. RANDALL PH.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1932284486
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1951561034
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20120327000848
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name RANDALL
Individual professional last name
Provider First Name MELISSA
Individual professional first name
Provider Middle Name L.
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1997
Individual professional's medical school graduation year
Primary Specialty PSYCHOLOGIST, CLINICAL
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 15300 VENTURA BLVD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 410
Group Practice or individual's line 2 address
City SHERMAN OAKS
Group Practice or individual's city
State CA
Group Practice or individual's state
Zip Code 914035849
Group Practice or individual's zip code (9 digits when available)
Phone Number 8183999069
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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