| Santa Monica Therapy, A Psychology Corporation | |
|
3301 Ocean Park Blvd Ste 210 Santa Monica CA 90405-3230 | |
| (310) 845-6720 | |
| Not Available |
| Full Name | Santa Monica Therapy, A Psychology Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 3301 Ocean Park Blvd Ste 210, Santa Monica, California |
| Authorized Official Name and Position | Timothy Wong (OWNER) |
| Authorized Official Contact | 3108456720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Monica Therapy, A Psychology Corporation 3301 Ocean Park Blvd Ste 210 Santa Monica CA 90405-3230 Ph: () - | Santa Monica Therapy, A Psychology Corporation 3301 Ocean Park Blvd Ste 210 Santa Monica CA 90405-3230 Ph: (310) 845-6720 |
| NPI Number | 1962967372 |
|---|---|
| Provider Enumeration Date | 02/11/2019 |
| Last Update Date | 02/11/2019 |
| Medicare PECOS PAC ID | 7012258346 |
|---|---|
| Medicare Enrollment ID | O20190413000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962967372 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Timothy Kenji Wong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043588775 PECOS PAC ID: 7214226190 Enrollment ID: I20160516002417 |
| Provider Name | Lori Meono |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093023079 PECOS PAC ID: 7315357621 Enrollment ID: I20201027002532 |
| Provider Name | Tara Fairbanks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750781118 PECOS PAC ID: 0446662761 Enrollment ID: I20201210001057 |
| Provider Name | Megan Brittany Cser Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730710518 PECOS PAC ID: 3870993033 Enrollment ID: I20210610001014 |
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