| Crossroads Institute For Psychotherapy And Assessment, Inc | |
|
2601 Airport Dr Suite 135 Torrance CA 90505-6140 | |
| (424) 201-1600 | |
| (424) 201-1601 |
| Full Name | Crossroads Institute For Psychotherapy And Assessment, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 2601 Airport Dr, Torrance, California |
| Authorized Official Name and Position | Soni Kim Monroe (PRESIDENT) |
| Authorized Official Contact | 4242011600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Institute For Psychotherapy And Assessment, Inc 2601 Airport Dr Suite 135 Torrance CA 90505-6140 Ph: (424) 201-1600 | Crossroads Institute For Psychotherapy And Assessment, Inc 2601 Airport Dr Suite 135 Torrance CA 90505-6140 Ph: (424) 201-1600 |
| NPI Number | 1831432806 |
|---|---|
| Provider Enumeration Date | 03/28/2013 |
| Last Update Date | 08/23/2016 |
| Medicare PECOS PAC ID | 9638391949 |
|---|---|
| Medicare Enrollment ID | O20141120001200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831432806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Secondary |
| Provider Name | Donna J Mendelson-gutierrez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053404392 PECOS PAC ID: 5991985897 Enrollment ID: I20110210000059 |
| Provider Name | Dianna M Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275664500 PECOS PAC ID: 7214242072 Enrollment ID: I20150824000341 |
| Provider Name | Andrew J Vandernoot |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043403785 PECOS PAC ID: 9830406925 Enrollment ID: I20150922003122 |
| Provider Name | Adam S Vogel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003282385 PECOS PAC ID: 6507157468 Enrollment ID: I20160623001181 |
| Provider Name | Torey D Troggio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336534106 PECOS PAC ID: 6204118672 Enrollment ID: I20170119000809 |
| Provider Name | Heather Christine Burton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710394218 PECOS PAC ID: 4385929702 Enrollment ID: I20170328001185 |
| Provider Name | Winnie Kao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275975294 PECOS PAC ID: 5395018873 Enrollment ID: I20170905002266 |
| Provider Name | Yu Chia Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528414851 PECOS PAC ID: 7012278559 Enrollment ID: I20180226002452 |
| Provider Name | Elizabeth Petrisca |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548542962 PECOS PAC ID: 5799018875 Enrollment ID: I20190604002305 |
| Provider Name | Timothy W Chen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578933495 PECOS PAC ID: 7113359035 Enrollment ID: I20191114002947 |
| Provider Name | Michael J Couse |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558856625 PECOS PAC ID: 4981035110 Enrollment ID: I20200504000593 |
| Provider Name | Emily P. Chen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003011230 PECOS PAC ID: 7214368794 Enrollment ID: I20200518000828 |
| Provider Name | Rachel M Miriani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922419068 PECOS PAC ID: 2264658772 Enrollment ID: I20201028001029 |
| Provider Name | Rebecca G Oliver Roman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447914544 PECOS PAC ID: 3173913084 Enrollment ID: I20211208003338 |
| Provider Name | Alex A Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366589889 PECOS PAC ID: 1254722762 Enrollment ID: I20211216002240 |
| Provider Name | Amelia Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508352717 PECOS PAC ID: 7214322163 Enrollment ID: I20220311001772 |
| Provider Name | Kristy Tram Nguyen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598309890 PECOS PAC ID: 3577940337 Enrollment ID: I20220517000483 |
| Provider Name | Susan Lok |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841846128 PECOS PAC ID: 2163806688 Enrollment ID: I20220901002575 |
| Provider Name | Grace E Chen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215311139 PECOS PAC ID: 6305291980 Enrollment ID: I20231017003024 |
| Provider Name | Jennifer Ham Kohagura |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699974105 PECOS PAC ID: 2567818982 Enrollment ID: I20231020002418 |
| Provider Name | Elizabeth Anne Ekeruo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780463026 PECOS PAC ID: 2365899929 Enrollment ID: I20231103002628 |
| Provider Name | Dale Hiebert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174227524 PECOS PAC ID: 0648629923 Enrollment ID: I20231212002067 |
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