POONAM NINA BANERJEE PHD NPI 1104143197

NPI Information

  • NPI: 1104143197
  • Provider Name: POONAM NINA BANERJEE, PHD
  • Classification: Clinical Neuropsychologist - 103G00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 17215 STUDEBAKER RD
    SUITE 300
    CERRITOS, CA
    ZIP 90703
  • Phone: (917) 370-6350

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NPI Details

Poonam Nina Banerjee, PHD is a clinical neuropsychologist in Cerritos, CA with 24 years of experience. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Poonam Nina Banerjee, PHD NPI is 1104143197. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

17215 STUDEBAKER RD
SUITE 300
CERRITOS, CA
ZIP 90703-548
Phone: (917) 370-6350
Fax: (949) 208-6981

The NPI 1104143197 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychotherapy, 30 minutes (HCPCS:90832)
  • Psychotherapy, 30 minutes (HCPCS:90832)
  • Psychiatric diagnostic evaluation (HCPCS:90791)

The enumeration date for this NPI number is 4/29/2010 and was last updated on 7/11/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103T00000XPsychologist018189NEW YORKNo
2103G00000XClinical NeuropsychologistPSY 24249CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1FH705AMEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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