MEDICARE: DR. JASON FELDMAN PH.D.

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	103G00000X	Clinical Neuropsychologist	35605	CA
2	103T00000X	Psychologist	35605	CA
3	103TB0200X	Cognitive & Behavioral Psychologist	35605	CA
4	103TC0700X	Clinical Psychologist	35605	CA
5	103TC2200X	Clinical Child & Adolescent Psychologist	35605	CA

General Provider Information

NPI Number	:	1053106435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON FELDMAN PH.D.

Provider Business Mailing Address
First Line	:	353 LUGANO WAY
Second Line	:
City	:	OAK PARK
State	:	CA
Zip	:	91377-5573
Country	:	US
Telephone Number	:	818-625-1117
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 TOWNSGATE RD STE 133
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-5834
Country	:	US
Telephone Number	:	805-265-3175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2025
Last Update Date	:	04/14/2025

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