Unknown Individual – Psychiatry Physician, NPI 1366479396

Unknown Individual is a healthcare provider. based in Rancho palos verdes, California. specializing in Psychiatry Physician. They hold a License No. CFE 18940 (CA). The NPI Number for Unknown Individual is 1366479396

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1366479396
Phone
(310) 377-3672
Address
30235 AVENIDA SELECTA
Deactivation Date
5 March 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 30235, Avenida Selecta, Rancho Palos Verdes, Los Angeles County, California, 90275, United States

    RANCHO PALOS VERDES, CA 902755424

    Phone: (310) 377-3672

    Fax: (310) 377-0502

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90275)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1366479396.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Rancho Palos Verdes, California as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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