Borrowed Star Psychology Group, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY17402 Issued in CA

Legal business name

BORROWED STAR PSYCHOLOGY GROUP, INC

Practice address

1294 W 6TH St
Suite 105
San Pedro, CA 90731-2987

Phone

(310) 902-6089

Fax

(310) 988-2883

NPI assigned

May 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melissa Arizpe, PSYD

Title

Director

Phone

(310) 902-6089

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1003020231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 W 6TH ST",
            "address_2": "SUITE 105",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312987",
            "telephone_number": "310-902-6089",
            "fax_number": "310-988-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 W 6TH ST",
            "address_2": "SUITE 105",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312987",
            "telephone_number": "310-902-6089",
            "fax_number": "310-988-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORROWED STAR PSYCHOLOGY GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "ARIZPE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-902-6089",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY17402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justine Bonilla
• Stephanie Bonilla
• Teresa Bonilla, SUPPORT SPECIALIST
• Alison Booth, L.AC., DIPL. AC.
• Cynthia Ann Borders
• Thomas Lee Bostwick, MD
• Issa M Botros, MD
• Natalia Boutilier-Marcus
• Michael Bowens Jr.
• Chih-Ying Bowker, MS, RRT

• Clinical Psychologist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.