STACEY M. BAYAN (NPI# 1164807954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164807954 |
| Entity Type | Individual |
| Full Name | STACEY M. BAYAN |
| Credential | PSYD |
| Practice Address |
11835 W Olympic Blvd., Ste 1265e Los Angeles CA 90064-5814 |
| Practice Telephone | 3102734843 |
| Practice Fax Number | 3102735056 |
| Mailing Telephone | 3102734843 |
| Mailing Fax Number | 3102735056 |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2018-01-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY27111 | CA | Behavioral Health & Social Service Providers |
| Street Address |
11835 W OLYMPIC BLVD., STE 1265E |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90064-5814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727597 | Barbara K. Polland | Marriage & Family Therapist | 10533 Rountree Rd., Los Angeles, CA 90064 | 2020-10-16 |
| 1912542994 | Reproductive Medicine Associates of Socal Ambulatory Surgery Center | Clinic/Center | 11500 W Olympic Blvd, Ste# 150, Los Angeles, CA 90064 | 2019-11-13 |
| 1376022012 | Payersdirect, Inc. | Radiology | 11845 W Olympic Blvd Ste 1100w, Los Angeles, CA 90064 | 2018-08-13 |
| 1013404136 | Jeannie Wakamatsu | Dietitian, Registered | 10312 Almayo Ave., Suite 6, Los Angeles, CA 90064 | 2018-04-13 |
| 1487153474 | Victor Louie | Behavior Technician | 11835 W Olympic Blvd Suite 140e, Los Angeles, CA 90064 | 2018-02-06 |
| 1538683842 | Ana Grinfeld | Behavioral Analyst | 11835 W Olympic Blvd Ste 140e, Los Angeles, CA 90064 | 2017-07-28 |
| 1407386089 | Ovsanna Stepanyan | Rehabilitation Practitioner | 11080 W Olimpic Blvd, La, CA 90064 | 2017-06-15 |
| 1952768012 | Grace Gayles | Behavioral Analyst | 11835 W. Olympic Blvd., Suite 140e, Los Angeles, CA 90064 | 2016-01-20 |
| 1669841003 | Jessica Hildebrandt | Occupational Therapy Assistant | 2446 S Westgate Ave, Los Angeles, CA 90064 | 2015-09-16 |
| 1033592571 | Joshua Busse | Family Medicine | 11845 Olympic Boulevard, Los Angeles, CA 90064 | 2015-07-01 |
| Find all providers in zip 90064 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366061707 | Talia Rose Seider | Clinical Neuropsychologist | 760 Westwood Plz Ste 37-360b, Los Angeles, CA 90024-5055 | 2020-04-15 |
| 1699394270 | Colin Jarred Gallagher | Clinical Neuropsychologist | 760 Westwood Plz # C8-854, Los Angeles, CA 90095-8353 | 2020-04-13 |
| 1528541554 | Marlene Garza | Clinical Neuropsychologist | 7381 La Tijera Blvd Unit 45312, Los Angeles, CA 90045-7017 | 2018-09-14 |
| 1922503739 | Douglas Polster | Clinical Neuropsychologist | 300 Stein Plaza Driveway, Los Angeles, CA 90095-0001 | 2018-03-26 |
| 1356875496 | Vindia G Fernandez | Clinical Neuropsychologist | 760 Westwood Plz # 47-429a, Los Angeles, CA 90095-8353 | 2017-04-15 |
| 1528500428 | Shou-chin Christine You | Clinical Neuropsychologist | Mpac Ucla Semel Institute, 760 Westwood Plaza, C8-852, Los Angeles, CA 90095-1759 | 2016-11-08 |
| 1053766139 | Larry C Bernard | Clinical Neuropsychologist | 8560 W Sunset Blvd, Suite 500, Los Angeles, CA 90069-2311 | 2016-04-26 |
| 1346630944 | Sloane Miller | Clinical Neuropsychologist | 1033 Gayley Ave Ste 208, Los Angeles, CA 90024-3426 | 2015-02-03 |
| 1932458155 | Nora Goudsmit | Clinical Neuropsychologist | 640 S San Vicente Blvd Ste 476, Los Angeles, CA 90048-4661 | 2012-09-04 |
| 1326309154 | Omar Mendoza Mahmood | Clinical Neuropsychologist | 10801 National Boulevard, Suite 611, Los Angeles, CA 90064-4170 | 2012-06-07 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90064 |
Please comment or provide details below to improve the information on STACEY M. BAYAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.