Organization Active NPI

Neuro Wellness Spa, a Medical PC

Doing business as Neuro Wellness Spa

  • Psychiatry Physician
  • Manhattan Beach, CA
National Provider Identifier
1003394149
Registry record updated Oct 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G78080 Issued in CA
Legal business name
NEURO WELLNESS SPA, A MEDICAL PC
Doing business as
Neuro Wellness Spa
Practice address
1101 N Sepulveda Blvd Ste 201
Manhattan Beach, CA 90266-5963
Phone
(310) 545-4450
Fax
(424) 423-0204
NPI assigned
Jul 31, 2018
Last updated
Oct 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2026

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

Authorized official

Name
Martha Koo, MDNPI 1497899728
Title
Cmo
Phone
(877) 847-3984

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X G78080 CA Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1101 N Sepulveda Blvd Ste 201
Manhattan Beach, CA 90266-5963

Mailing address

18119 Prairie Ave
Torrance, CA 90504-3739
Phone (877) 847-3984

Other practice location 1

1000 Texas St Ste G
Fairfield, CA 94533-5700
Phone (877) 847-3984

Other practice location 2

1777 Hamilton Ave Ste 2140
San Jose, CA 95125-5421
Phone (877) 847-3984

Other practice location 3

5743 Corsa Ave Ste 107
Westlake Village, CA 91362-6474
Phone (877) 847-3984

Other practice location 4

7777 Alvarado Rd Ste 408B
LA Mesa, CA 91942-8248
Phone (877) 847-3984

Other practice location 5

2656 29th St Ste 202
Santa Monica, CA 90405-2984
Phone (877) 847-3984

Other practice location 6

5838 E Naples Plz
Long Beach, CA 90803-5039
Phone (877) 847-3984

Other practice location 7

13400 Washington Blvd Ste 105
Marina Del Rey, CA 90292-5632
Phone (877) 847-3984

Other practice location 8

3600 Lomita Blvd Ste 200
Torrance, CA 90505-3900
Phone (310) 545-4450

Other practice location 9

350 S Lake Ave Ste 260
Pasadena, CA 91101-3530
Phone (877) 847-3984

Other practice location 10

200 Newport Center Dr Ste 111
Newport Beach, CA 92660-7502
Phone (877) 847-3984

Other practice location 11

764 P St Ste 19
Fresno, CA 93721-2741
Phone (877) 847-3984

Other practice location 12

475 S State College Blvd
Brea, CA 92821-5726
Phone (877) 847-3984

Other practice location 13

22706 Aspan St Ste 501
Lake Forest, CA 92630-1603
Phone (877) 847-3984

Other practice location 14

8383 Wilshire Blvd Ste 520
Beverly Hills, CA 90211-2437
Phone (877) 847-3984

Other practice location 15

1101 N Sepulveda Blvd Ste 202
Manhattan Beach, CA 90266-5963
Phone (877) 847-3984

Other practice location 16

18411 Crenshaw Blvd Ste 360
Torrance, CA 90504-5060
Phone (877) 847-3984

Other practice location 17

37 Creek Rd Ste 140
Irvine, CA 92604-4724
Phone (877) 847-3984

Other practice location 18

18411 Crenshaw Blvd Ste 320
Torrance, CA 90504-5044
Phone (877) 847-3984

Other practice location 19

16530 Ventura Blvd Ste 625
Encino, CA 91436-5009
Phone (877) 847-3984

Other practice location 20

3400 Inland Empire Blvd Ste 101
Ontario, CA 91764-5577
Phone (877) 847-3984

Other practice location 21

6850 Brockton Ave Ste 209
Riverside, CA 92506-3815
Phone (877) 847-3984

Other names 1

  • Neuro Wellness Spa Doing business as

National Provider Directory

National Provider Directory

Locations

8383 Wilshire Blvd
Ste 520
Beverly Hills, CA 90211

16530 Ventura Blvd
Ste 625
Encino, CA 91436

764 P St
Ste 19
Fresno, CA 93721

22706 Aspan St
Ste 501
Lake Forest, CA 92630
Phone (949) 565-4138

5838 E Naples Plz
Long Beach, CA 90803
Phone (877) 624-1427

1011 N Sepulveda Blvd Ste 202
Manhattan Beach, CA 90266

1101 N Sepulveda Blvd
Ste 201
Manhattan Beach, CA 90266
Phone (310) 545-4450

13400 Washington Blvd
Ste 105
Marina del Rey, CA 90292
Phone (310) 200-8957

350 S Lake Ave
Ste 260
Pasadena, CA 91101
Phone (424) 352-3633

2656 29th St
Ste 202
Santa Monica, CA 90405
Phone (310) 503-0221

18411 Crenshaw Blvd
Ste 320
Torrance, CA 90504
Phone (213) 268-5337

18411 Crenshaw Blvd
Ste 360
Torrance, CA 90504
Phone (213) 340-2613

3600 Lomita Blvd
Ste 200
Torrance, CA 90505
Phone (310) 545-4450

5743 Corsa Ave
Ste 107
Westlake Village, CA 91362

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793318400000",
    "number": "1003394149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18119 PRAIRIE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905043739",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N SEPULVEDA BLVD STE 201",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902665963",
            "telephone_number": "310-545-4450",
            "fax_number": "424-423-0204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Texas St Ste G",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945335700",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1777 Hamilton Ave Ste 2140",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951255421",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5743 Corsa Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Westlake Village",
            "state": "CA",
            "postal_code": "913626474",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7777 Alvarado Rd Ste 408B",
            "address_purpose": "LOCATION",
            "city": "LA Mesa",
            "state": "CA",
            "postal_code": "919428248",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2656 29th St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904052984",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5838 E Naples Plz",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908035039",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13400 Washington Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Marina Del Rey",
            "state": "CA",
            "postal_code": "902925632",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Lomita Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905053900",
            "country_code": "US",
            "telephone_number": "310-545-4450",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 S Lake Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911013530",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Newport Center Dr Ste 111",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926607502",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "764 P St Ste 19",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937212741",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "475 S State College Blvd",
            "address_purpose": "LOCATION",
            "city": "Brea",
            "state": "CA",
            "postal_code": "928215726",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22706 Aspan St Ste 501",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "CA",
            "postal_code": "926301603",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8383 Wilshire Blvd Ste 520",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902112437",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 N Sepulveda Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Manhattan Beach",
            "state": "CA",
            "postal_code": "902665963",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18411 Crenshaw Blvd Ste 360",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905045060",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 Creek Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926044724",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18411 Crenshaw Blvd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905045044",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16530 Ventura Blvd Ste 625",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914365009",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Inland Empire Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917645577",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6850 Brockton Ave Ste 209",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925063815",
            "country_code": "US",
            "telephone_number": "877-847-3984",
            "fax_number": "424-423-0204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEURO WELLNESS SPA, A MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2026-10-30",
        "certification_date": "2026-10-30",
        "status": "A",
        "authorized_official_last_name": "KOO",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "877-847-3984",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G78080",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neuro Wellness Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manhattan Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2026; 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.