| American Psychological Corporation, Inc. | |
|
4712 Admiralty Way Ste 591 Marina Del Rey CA 90292-6905 | |
| (310) 850-1699 | |
| (760) 859-3877 |
| Full Name | American Psychological Corporation, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 4712 Admiralty Way Ste 591, Marina Del Rey, California |
| Authorized Official Name and Position | Elena Balashova-shamis (PRESIDENT/ OWNER) |
| Authorized Official Contact | 3104860404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Psychological Corporation, Inc. Po Box 12212 Marina Del Rey CA 90295-3212 Ph: () - | American Psychological Corporation, Inc. 4712 Admiralty Way Ste 591 Marina Del Rey CA 90292-6905 Ph: (310) 850-1699 |
| NPI Number | 1053819672 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/12/2022 |
| Medicare PECOS PAC ID | 1355603671 |
|---|---|
| Medicare Enrollment ID | O20180327001726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053819672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (California) | Primary |
| Provider Name | Elena Balashova-shamis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740705367 PECOS PAC ID: 2567738149 Enrollment ID: I20171026000851 |
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