How we work together — and what it costs

Conditions & concerns

My practice centers on depression, anxiety, and trauma in high-functioning adults — people who are capable and often accomplished, and who carry a quiet sense that something isn't right beneath the surface. Many of the concerns below travel together, and none requires a tidy diagnostic label to be worth taking seriously.

• Depression From a persistent sense of languishing — functioning on the outside while feeling flat or empty on the inside — to major depression severe enough that escape has at least crossed your mind.
• Anxiety Generalized anxiety, chronic worry, and the exhausting inner machinery that often drives it: perfectionism, overthinking, and the paralysis that comes from analyzing every decision.
• Trauma & PTSD Including developmental and relational trauma — the early, pervasive experiences that don't always announce themselves with a single clear story, but show up everywhere in how a person moves through the world.
• The patterns underneath People-pleasing, difficulty setting boundaries, self-worth tied to achievement, and the particular exhaustion of being the capable one everyone else relies on.
• Living between cultures The tensions of belonging to two worlds at once — holding family expectations shaped by one culture while building a life in another, and questioning whether you are "enough" of either.
• Not sure where you fit? Many patients arrive without a diagnosis, only a sense that they could be living more fully than they are. That is a legitimate reason to seek care, and it is often where the most rewarding work begins.

Treatment modalities

Every treatment I offer flows from the same premise: you are a person with a history, not a collection of symptoms. The modalities below are not separate services so much as facets of one integrated approach.

• Psychodynamic Psychiatry Humans are complex, and that complexity develops from the moment we are born. We learn how to treat ourselves and others based on what we observed in our caregivers and those closest to us. That learning happens unconsciously, and it is usually enough to guide us through most of life — yet it is common for those same patterns to make other areas of living quite difficult. Psychodynamic psychiatry lets me look at those unconscious patterns by paying attention to how you show up in session, whether we are meeting for psychotherapy or for medication management, so that we get at the psychological and not only the medical. Patterns that were adaptive once, even necessary, can become the very things that keep you stuck now, and understanding them is only half the work. The other half is trying a different way of being: saying what you would usually stifle, or letting someone see what you usually hide, and finding that the relationship holds. Our work together is a safe place to try that first, before carrying it into the rest of your life. That is what can produce more durable and significant change. Whether it is with me or with a provider I recommend, my aim is to help you understand the hidden but deeply impactful psychological aspects of yourself much more fully.
• Medication Management Medications can be extremely helpful to people who would otherwise suffer needlessly. The way I approach medication management is to use the minimum effective dose to get you through difficult transitions, while we work together on the underlying structural concerns — so that, when clinically appropriate, medication is often needed at a lower dose in the long run, if at all. My management also includes education on what these medications are, why we are using them, and what to expect, so that you are never simply taking a pill because I said so. We are co-creating the best path to your improvement.
• Lab Testing Your psychiatric and psychological health matter. So does your medical health. Medical issues can masquerade as mental health ones, so I use lab testing, along with pertinent medical screening questions, to make sure we are considering your health globally rather than from a narrowly psychiatric point of view. As a psychiatrist, I do not want this to be a case of "to a hammer, everything looks like a nail." When labs are needed, they are drawn at an outside laboratory, which typically bills your health insurance using a diagnosis code. I am glad to talk through that, and any alternatives, before ordering anything.

What you can expect to pay

All services are provided on a private-pay basis. I do not bill insurance directly, which allows us to work together without the constraints that managed care places on treatment length, frequency, and approach. Your card on file is charged 8 hours before each appointment.

Whatever its length or focus, every appointment is held within a psychodynamic frame. A medication decision, a brief check-in, or a message between visits is understood in the context of your history and of our work together.

Returning after a break: if it has been six months or more since your last appointment, your first visit back is a 50-minute re-establishment visit at $500. It allows time to update your history, review what has changed, and revise the treatment plan before regular follow-ups resume. If your care has been formally closed, I may ask you to begin with a new initial evaluation.

Other fees: lab work is billed by the laboratory, usually to your health insurance, and I review the results with you at your next appointment at no additional charge, or sooner if something needs attention. Clinical services between appointments, such as letters, forms, prior authorizations, calls with your other clinicians or family, and clinical questions answered by secure message, are $50 per item or per 10 minutes, and I generally waive them for brief requests. Scheduling and billing questions are never charged.

How out-of-network reimbursement works

I am not in-network with any insurance plan. However, if you have a PPO or POS insurance plan — common with employer-sponsored coverage — you likely have out-of-network benefits that can meaningfully reduce your out-of-pocket cost.

Many patients are surprised to discover they can often recover 50–70% of session fees through their insurance after meeting their deductible, though this varies by plan. This can bring the effective cost of a $425 session to somewhere between $130 and $210 per visit, depending on your plan.

How the process works

1. You pay through your card on file. The full fee is charged 8 hours before each appointment. I accept all major credit and debit cards and HSA/FSA cards; established patients may also pay by bank transfer (ACH).
2. I provide a superbill. After each visit or once a month, as we agree, I generate a detailed receipt — called a superbill — that includes the diagnostic and billing codes your insurance requires to process a reimbursement claim.
3. You submit the superbill to your insurer. Most plans allow online or app-based submission. Some employers also offer third-party services that handle this on your behalf automatically.
4. Your insurer reimburses you directly. Timelines vary by plan, but reimbursement checks or transfers often arrive within a few weeks of submission.

Before your first appointment, I encourage you to call the member services number on your insurance card and ask: "What are my out-of-network mental health benefits, and what is my out-of-network deductible?" I am happy to help you understand what you learn.

When the standard fee is out of reach

I hold a small number of reduced-fee appointments for patients for whom the standard fee would create a genuine barrier to care — not a stretch, but a true obstacle.

Things people often ask

• What is psychodynamic psychiatry?

  It is psychiatry that attends to the whole person, not only the symptoms. The psychodynamic part rests on a simple observation — much of what shapes how we feel, relate, and react was learned early and operates outside our awareness, often long after it stopped serving us. In practice, I listen not only to what you tell me but to how those patterns show up between us, and we use what we notice to understand what keeps recreating the problem. The psychiatry part means I am a physician — I can evaluate the medical side, prescribe when medication would help, and hold both kinds of understanding at once.

• How is seeing a psychiatrist who does therapy different from seeing a therapist and a prescriber separately?

  In the more common arrangement, a therapist sees you weekly while a psychiatrist or nurse practitioner sees you for brief medication visits, and the two may rarely speak. That can work well, and I am glad to be the prescriber alongside a therapist you already trust. When one physician does both, though, nothing is lost in translation. I know what was happening in your life when a medication seemed to stop working, and I can tell whether a dip in mood calls for a dose change or for understanding what just got stirred up. Medication decisions become part of the conversation rather than a separate transaction, which often means we can use less of it.

• Do you accept Medicare or Medi-Cal?

  No. I am not enrolled in Medicare and have not filed a formal opt-out, which means federal law does not currently permit me to see Medicare beneficiaries — including Medicare Advantage plans — even on a private-pay basis. I also do not accept new patients who are enrolled in Medi-Cal. Medi-Cal members can receive mental health care, including psychiatric care, at no cost through their Medi-Cal health plan or the Los Angeles County Department of Mental Health Help Line (1-800-854-7771), and I am glad to help you find the right starting point. If you become eligible for Medi-Cal while already in care with me, we will talk through your options, including continuing privately.

• Why don't you take insurance?

  Insurance panels often require brief sessions, limit treatment frequency, or mandate diagnostic codes that shape — and often distort — the clinical record. Depth psychiatry works differently — it requires time, continuity, and the freedom to follow what is actually present rather than what a utilization reviewer approves. Remaining outside that system preserves the quality and continuity of care.

• How do I know if my insurance plan has out-of-network benefits?

  Call the member services number on your insurance card and ask specifically about out-of-network mental health or behavioral health benefits. Key questions: Is there an out-of-network deductible? What percentage does the plan cover after the deductible? Is prior authorization required? I can help you interpret what you learn.

• Can I use my FSA or HSA card to pay directly at your office?

  Yes. HSA and FSA cards are charged the same way as any other card on file, and I also ask for a second, general-purpose card for late-cancellation and missed-appointment fees and for letters and forms, since those aren't eligible medical expenses. Psychiatric services are generally a qualified medical expense, though your plan administrator may request documentation — I provide superbills, after each visit or monthly as we agree, that typically satisfy this requirement.

• What is your cancellation policy?

  Please cancel or reschedule at least one business day ahead, by the same time of day as your appointment: for a Wednesday 2:00 PM appointment, that means by Tuesday at 2:00 PM. Business days are Monday through Thursday, so a Monday appointment must be changed by the preceding Thursday. Late cancellations and missed appointments are charged the full session fee, and arriving 10 or more minutes late may be treated as a missed appointment. Because your card is charged 8 hours before each appointment, a late cancellation or missed appointment simply keeps that charge, as a fee rather than a visit. The full policy is part of the office agreement you sign before your first visit. It exists because reserved time is genuinely set aside for you — and because the regularity of our appointments is itself part of how depth-oriented work functions.

• Can appointments be held by video?

  Yes, for many follow-ups. Your first appointment, the initial evaluation, is in person at my Pasadena office, and I see every patient in person at least once every six months. Being in the same room conveys what a screen tends to flatten — silences, posture, the small shifts that happen when a conversation nears something painful, and the felt sense of the relationship itself. That fuller picture matters both for understanding you and for prescribing safely. Video appointments are available to patients who are physically in California at the time of the visit. If an in-person visit is difficult for you because of a disability or another circumstance, please ask; I consider exceptions individually.

• What happens if I need help between sessions, or in a crisis?

  This is a solo outpatient practice. Between appointments, I am available by phone or secure message Monday through Thursday, 8:00 AM to 5:00 PM, and typically reply within two business days. There is no after-hours or emergency coverage. If you are experiencing a mental health emergency, please call or text 988, call 911, or go to your nearest emergency room.

• Who tends to do well in this practice?

  People who are curious about themselves, even when that curiosity comes with some dread. Most of the people I work with are doing well by outside measures and want more than symptom relief — they want to understand why the same feelings and relationships keep repeating. It helps to be able to commit to regular appointments for a while, since depth-oriented work builds on continuity, and to be open to noticing what happens in the room between us. You don't need a diagnosis, a clear sense of what's wrong, or certainty that this will help. Wanting to find out is enough to start.

• What isn't a good fit for this practice?

  This practice is not equipped to treat acute suicidality, active psychosis or mania, eating disorders requiring medical monitoring, primary substance use disorder, or forensic and disability evaluations, and I do not see patients under 18. If any of these apply to you, your primary care clinician or your health plan's member services line can help you find the right level of care, and if you are in crisis, please call or text 988.

• What is your approach to medications like benzodiazepines and stimulants?

  I prescribe these thoughtfully and at the minimum effective dose, when clinically appropriate, as part of an integrated treatment plan rather than as a first-line or standalone intervention. I'm happy to discuss my approach to any specific medication during your initial evaluation.

• Do you offer TMS (transcranial magnetic stimulation)?

  Not in this practice. If TMS might be right for you, I'm glad to talk through whether it fits and where it's offered.

• I already have a therapist. Can I still see you?

  Yes — this is one of the most common ways people work with me. If you're already in therapy, I'm glad to provide medication management only, typically through the 25-minute follow-up track, and to collaborate with your therapist with your consent. I won't take over the therapeutic work you already have in place.

• Is everything we discuss confidential?

  Your care is confidential within the limits of California and federal law. I don't submit claims to insurance companies as part of routine treatment, and any records you choose to share — for example, a superbill for out-of-network reimbursement — go directly to you, not to a third party. If a medication needs prior authorization, I share with your insurer only what it requires to review the request. Like any licensed clinician, I have narrow, legally defined obligations to disclose information without consent in specific circumstances. Our Notice of Privacy Practices describes these in detail.