| Pacifica Neuropsychology Center | |
|
461 W 6th St, Suite 211 San Pedro CA 90731-2694 | |
| (310) 547-0084 | |
| (310) 833-5672 |
| Full Name | Pacifica Neuropsychology Center |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 461 W 6th St, Suite 211, San Pedro, California |
| Authorized Official Name and Position | Marisa Mares (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3105470084 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacifica Neuropsychology Center 461 W 6th St, Suite 211 San Pedro CA 90731-2694 Ph: (310) 547-0084 | Pacifica Neuropsychology Center 461 W 6th St, Suite 211 San Pedro CA 90731-2694 Ph: (310) 547-0084 |
| NPI Number | 1962783951 |
|---|---|
| Provider Enumeration Date | 09/02/2011 |
| Last Update Date | 01/26/2017 |
| Medicare PECOS PAC ID | 9133444524 |
|---|---|
| Medicare Enrollment ID | O20150205001551 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962783951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY 19781 (California) | Primary |
| 106H00000X | Marriage & Family Therapist | MFC 42200 (California) | Secondary |
| Provider Name | Marisa Mares |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033203054 PECOS PAC ID: 9436119641 Enrollment ID: I20041012001573 |
| Provider Name | Jorrie S Mackenzie |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447512744 PECOS PAC ID: 5890008866 Enrollment ID: I20150720002448 |
Borrowed Star Psychology Group, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1294 W 6th St, Suite 105, San Pedro, CA 90731 Phone: 310-902-6089 Fax: 310-988-2883 | |
Melissa F. Pedersen, Ma Mft Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 739 W 9th St, San Pedro, CA 90731 Phone: 310-801-8152 | |
Lily Psychological Consultation Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2183 W Paseo Del Mar, San Pedro, CA 90732 Phone: 415-273-9233 | |
Nlv Psychotherapy & Consulting Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 S Harbor Blvd, San Pedro, CA 90731 Phone: 714-606-8483 | |
Lorin Odonnell Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 W 9th St Ste 201, San Pedro, CA 90731 Phone: 310-748-4511 | |
La County Department Of Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 W 7th St, San Pedro, CA 90731 Phone: 310-519-6224 | |
Los Angeles County Department Of Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 Ferry St, San Pedro, CA 90731 Phone: 213-947-6271 Fax: 213-351-2490 |