SPORTS CONCUSSION INSTITUTE A PSYCHOLOGY GROUP INC (NPI# 1194896498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194896498 |
| Entity Type | Organization |
| Organization Name | SPORTS CONCUSSION INSTITUTE A PSYCHOLOGY GROUP INC |
| Practice Address |
5230 Pacific Concourse Dr Suite 300 Los Angeles CA 90045-6200 |
| Mailing Address |
5230 Pacific Concourse Drive Suite 300 Los Angeles CA 90045-6200 |
| Practice Telephone | 3106439595 |
| Practice Fax Number | 3106435180 |
| Mailing Telephone | 3106439595 |
| Mailing Fax Number | 3106435180 |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2017-01-09 |
| Authorized Official Name | DR. TONY L STRICKLAND (OWNER PROVIDER) |
| Authorized Official Telephone | 3106439595 |
| Authorized Official Credential | P.H.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY12223 | CA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ50434Y | 01 |
| Street Address |
5230 PACIFIC CONCOURSE DR SUITE 300 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90045-6200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417941535 | Julian E Girod | Orthopaedic Surgery | 5230 Pacific Concourse Dr, Suite 110, Los Angeles, CA 90045-6200 | 2005-09-02 |
| 1518314616 | Arlizbeth Estrada Arizanga Luna | Nurse Practitioner | 5230 Pacific Concourse Dr, Suite 100, Los Angeles, CA 90045-6200 | 2016-05-18 |
| 1386064350 | Arthritis Associates of Southern California | Internal Medicine | 5230 Pacific Concourse Dr, Suite 100, Los Angeles, CA 90045-6200 | 2014-04-17 |
| 1033396643 | Stanely Tobias | Internal Medicine | 5230 Pacific Concourse Dr, Suite 100, Los Angeles, CA 90045-6200 | 2008-01-25 |
| 1558564740 | Julian E. Girod, M.d., Inc | Orthopaedic Surgery | 5230 Pacific Concourse Dr, Suite 110, Los Angeles, CA 90045-6200 | 2007-06-06 |
| 1093886269 | Dwight Wayne Malone | Family Medicine | 5230 Pacific Concourse Dr, Suite 110, Los Angeles, CA 90045-6200 | 2006-11-10 |
| 1457422628 | Dwight W. Malone, M.d., Inc | Family Medicine | 5230 Pacific Concourse Dr, 110, Los Angeles, CA 90045-6200 | 2006-11-10 |
| 1841220373 | Gary Richard Feldman | Internal Medicine | 5230 Pacific Concourse Dr, Suite 100, Los Angeles, CA 90045-6200 | 2006-07-03 |
| 1205862752 | Pacific Arthritis Care Center Inc. | Internal Medicine | 5230 Pacific Concourse Dr, Suite 100, Los Angeles, CA 90045-6200 | 2006-06-25 |
| 1962447060 | Ali Ashrafzadeh | Internal Medicine | 5230 Pacific Concourse Dr, Suite 100, Los Angeles, CA 90045-6200 | 2006-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396388849 | Laska Dental Inc | Dentist | 5602 W Manchester Ave, Los Angeles, CA 90045 | 2019-10-28 |
| 1245889179 | Ana Arias | Physical Therapist | 6801 Terrace Drive, Suite 200, Los Angeles, CA 90045 | 2019-09-04 |
| 1144719410 | Family Dental Care 4 You | Dentist | 5602 W. Manchester Ave, Los Angeles, CA 90045 | 2018-05-02 |
| 1821504002 | Rhonda Taylor | Counselor | 8703 La Tijera Blvd Ste 201, Los Angeles, CA 90045 | 2017-12-24 |
| 1114436839 | Blanca Melisa Gomez I | Case Manager/Care Coordinator | 7423 1/4 S Sepulveda Blvd, Los Angeles, CA 90045 | 2017-09-26 |
| 1639688831 | Kalila Magbanua-stein | Counselor | 8618 La Tijera Blvd., Suite 200, Los Angeles, CA 90045 | 2017-09-20 |
| 1568984185 | Angela Mull | Marriage & Family Therapist | 8616 Latijera Blvd, Suite 307, Los Angeles, CA 90045 | 2017-07-14 |
| 1386171585 | Patricia Ann Bridewell | Registered Nurse | 5245 Concourse Drive, Suite 100, Los Angeles, CA 90045 | 2017-05-18 |
| 1679937627 | Thelese Consulting Group | Community/Behavioral Health | 8929 S. Sepulveda Blvd, Suite 400, Los Angeles, CA 90045 | 2016-04-06 |
| 1568823318 | Keith Romalis Ellison | Specialist/Technologist | One Lmu Drive, Gersten Pavilion - Athletic Training Room, Los Angeles, CA 90045 | 2016-03-08 |
| Find all providers in zip 90045 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366061707 | Talia Rose Seider | Clinical Neuropsychologist | 760 Westwood Plz Ste 37-360b, Los Angeles, CA 90024-5055 | 2020-04-15 |
| 1699394270 | Colin Jarred Gallagher | Clinical Neuropsychologist | 760 Westwood Plz # C8-854, Los Angeles, CA 90095-8353 | 2020-04-13 |
| 1528541554 | Marlene Garza | Clinical Neuropsychologist | 7381 La Tijera Blvd Unit 45312, Los Angeles, CA 90045-7017 | 2018-09-14 |
| 1922503739 | Douglas Polster | Clinical Neuropsychologist | 300 Stein Plaza Driveway, Los Angeles, CA 90095-0001 | 2018-03-26 |
| 1356875496 | Vindia G Fernandez | Clinical Neuropsychologist | 760 Westwood Plz # 47-429a, Los Angeles, CA 90095-8353 | 2017-04-15 |
| 1528500428 | Shou-chin Christine You | Clinical Neuropsychologist | Mpac Ucla Semel Institute, 760 Westwood Plaza, C8-852, Los Angeles, CA 90095-1759 | 2016-11-08 |
| 1053766139 | Larry C Bernard | Clinical Neuropsychologist | 8560 W Sunset Blvd, Suite 500, Los Angeles, CA 90069-2311 | 2016-04-26 |
| 1164807954 | Stacey M. Bayan | Clinical Neuropsychologist | 11835 W Olympic Blvd., Ste 1265e, Los Angeles, CA 90064-5814 | 2015-07-22 |
| 1346630944 | Sloane Miller | Clinical Neuropsychologist | 1033 Gayley Ave Ste 208, Los Angeles, CA 90024-3426 | 2015-02-03 |
| 1932458155 | Nora Goudsmit | Clinical Neuropsychologist | 640 S San Vicente Blvd Ste 476, Los Angeles, CA 90048-4661 | 2012-09-04 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90045 |
Please comment or provide details below to improve the information on SPORTS CONCUSSION INSTITUTE A PSYCHOLOGY GROUP INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.