Evergreen Psychology New York PC
NPI 1902755325ActiveOrganization· Psychologist, Cognitive & Behavioral· Los Angeles, CA
Psychologist, Cognitive & Behavioral in Los Angeles, California, registered in NPPES in January 2026. The authorized official on file is Daniel Fenton, PHD, Head Of Neuropsychological Services. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1902755325 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 27, 2026 |
| Last updated in NPPES | Nov 5, 2026 |
| Certified by provider | Nov 5, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Cognitive & Behavioral Primary | 103TB0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL); Part B Supplier - Clinic/Group Practice (MA) |
|---|
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