| Stella Panos Phd A Professional Psychology Corporation | |
|
720 Wilshire Blvd Ste 204 Santa Monica CA 90401-1737 | |
| (424) 345-6377 | |
| Not Available |
| Full Name | Stella Panos Phd A Professional Psychology Corporation |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 720 Wilshire Blvd Ste 204, Santa Monica, California |
| Authorized Official Name and Position | Stella Panos (PRESIDENT) |
| Authorized Official Contact | 4243456377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stella Panos Phd A Professional Psychology Corporation 8967 Cadillac Ave Los Angeles CA 90034-2056 Ph: (562) 964-1906 | Stella Panos Phd A Professional Psychology Corporation 720 Wilshire Blvd Ste 204 Santa Monica CA 90401-1737 Ph: (424) 345-6377 |
| NPI Number | 1962223230 |
|---|---|
| Provider Enumeration Date | 10/21/2024 |
| Last Update Date | 10/21/2024 |
| Certification Date | 10/20/2024 |
| Medicare PECOS PAC ID | 1355877804 |
|---|---|
| Medicare Enrollment ID | O20241209001082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962223230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Stella E Panos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104252352 PECOS PAC ID: 3779713375 Enrollment ID: I20140227000487 |
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