| Archeus Psychological Associates, Inc. | |
|
22330 Hawthorne Blvd Ste 207 Torrance CA 90505-2552 | |
| (424) 271-2933 | |
| Not Available |
| Full Name | Archeus Psychological Associates, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 22330 Hawthorne Blvd, Torrance, California |
| Authorized Official Name and Position | Mark J Ingram (PSYCHOLOGIST/CEO) |
| Authorized Official Contact | 4242712933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Archeus Psychological Associates, Inc. 28625 S Western Ave # 2024 Rancho Palos Verdes CA 90275-0810 Ph: (424) 271-2933 | Archeus Psychological Associates, Inc. 22330 Hawthorne Blvd Ste 207 Torrance CA 90505-2552 Ph: (424) 271-2933 |
| NPI Number | 1598108912 |
|---|---|
| Provider Enumeration Date | 04/16/2013 |
| Last Update Date | 02/12/2024 |
| Certification Date | 02/09/2024 |
| Medicare PECOS PAC ID | 2961833173 |
|---|---|
| Medicare Enrollment ID | O20200502000000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598108912 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | 24268 (California) | Secondary |
| 103TC0700X | Psychologist - Clinical | 24268 (California) | Primary |
| Provider Name | Mark J Ingram |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477846160 PECOS PAC ID: 7618148958 Enrollment ID: I20200505001549 |
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