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DR. JON-PATRIK PEDERSEN PH.D.
NPI 1376695635
Psychologist - Clinical in Pasadena, CA

Active since January 17, 2007Opted out of Medicare · through Feb 13, 2028
102 N MADISON AVE, PASADENA, CA 91101(626) 449-4737 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jon-patrik Pedersen Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JON-PATRIK PEDERSEN PH.D. (NPI 1376695635) is an individual clinical provider in Pasadena, California, licensed in California (PSY11837) and active in the NPI registry since January 2007. He has opted out of Medicare through February 13, 2028.

NPPES Registry Identity

NPI1376695635
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JON-PATRIK PEDERSENCredential: PH.D.
Location Address102 N MADISON AVEPasadena, CA 91101-1710
Mailing Address102 N Madison AvePasadena, CA 91101-1710 · (626) 449-4737
Phone(626) 449-4737
Sole ProprietorYes
Enumeration DateJanuary 17, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1376695635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · PSY11837
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
102 N MADISON AVE, Pasadena, CA 91101
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jon-patrik Pedersen Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 13, 2026 through February 13, 2028.

Opt-Out Effective DateFebruary 13, 2026
Opt-Out In Effect ThroughFebruary 13, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GEORGINA MONCHO PHD
Psychologist
102 N MADISON AVE
PASADENA, CA 91101
Los Angeles County (323) 240-7987
DR. RICARDO ALEJANDRO MONCHO PH.D.
Psychologist (Clinical)
102 N MADISON AVE
PASADENA, CA 91101
Los Angeles County (323) 793-6635
AURELIA RICKETTS PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
102 N MADISON AVE
PASADENA, CA 91101
Los Angeles County (626) 602-8530

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jon-patrik Pedersen's NPI number?

The NPI number for Jon-patrik Pedersen is 1376695635. It was assigned to this individual provider in the NPPES registry on January 17, 2007.

Where is Jon-patrik Pedersen located?

Jon-patrik Pedersen practices at 102 N Madison Ave, Pasadena, CA 91101. The listed phone number is (626) 449-4737.

What is Jon-patrik Pedersen's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jon-patrik Pedersen enrolled in Medicare?

No. Jon-patrik Pedersen has opted out of Medicare through February 13, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jon-patrik Pedersen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.