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DR. MITZEN BLACK PSYD
NPI 1467633735
Psychologist - Clinical in Los Angeles, CA

Active since November 15, 2007PECOS Enrolled
1625 SCHRADER BLVD, LOS ANGELES, CA 90028(323) 993-7500 Get Directions Write a Review

NPPES record last updated: October 26, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 26, 2020, Dec 13, 2018 (2 updates tracked since 2018).

About Dr. Mitzen Black Psyd NPPES

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

DR. MITZEN BLACK PSYD (NPI 1467633735) is an individual clinical provider in Los Angeles, California, licensed in California (30574) and active in the NPI registry since November 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467633735
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. MITZEN BLACKCredential: PSYD
Location Address1625 SCHRADER BLVDLos Angeles, CA 90028-6213
Mailing Address1625 Schrader BlvdLos Angeles, CA 90028-6213
Phone(323) 993-7500
Sole ProprietorNo
Enumeration DateNovember 15, 2007
Last NPPES UpdateOctober 26, 20202 updates tracked since enumeration
NPPES CertifiedOctober 26, 2020
✔ NPI 1467633735 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 · 30574
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.
1625 SCHRADER BLVD, Los Angeles, CA 90028
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mitzen Black Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90028 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DR. KEVIN THOMAS MARX PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1625 SCHRADER BLVD
LOS ANGELES, CA 90028
Los Angeles County (323) 993-7467
DEVIKA SHANKAR
Rehabilitation Practitioner
1625 SCHRADER BLVD
LOS ANGELES, CA 90028
Los Angeles County (323) 993-7504
AUDREY MACASIEB
Registered Nurse
1625 SCHRADER BLVD
LOS ANGELES, CA 90028
Los Angeles County (323) 993-8910
ANEDRA PRESSLEY RN
Registered Nurse
1625 SCHRADER BLVD
LOS ANGELES, CA 90028
Los Angeles County (323) 993-7434
ALAN GAONA
Rehabilitation Practitioner
1625 SCHRADER BLVD
LOS ANGELES, CA 90028
Los Angeles County (323) 993-8971
MR. RISHAD LAWYER LMFT
Marriage & Family Therapist
1625 SCHRADER BLVD
LOS ANGELES, CA 90028
Los Angeles County (323) 993-7500
ACE SEIDEL
Psychologist (Clinical)
1625 SCHRADER BLVD
LOS ANGELES, CA 90028
Los Angeles County (213) 466-5021
JULIE MOORE
Psychologist (Clinical)
1625 SCHRADER BLVD
LOS ANGELES, CA 90028
Los Angeles County (323) 860-5889

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 Mitzen Black's NPI number?

The NPI number for Mitzen Black is 1467633735. It was assigned to this individual provider in the NPPES registry on November 15, 2007.

Where is Mitzen Black located?

Mitzen Black practices at 1625 Schrader Blvd, Los Angeles, CA 90028. The listed phone number is (323) 993-7500.

What is Mitzen Black's specialty?

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

Is Mitzen Black enrolled in Medicare?

Yes. Mitzen Black is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mitzen Black was last updated on October 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.