American Psychological Corporation, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

AMERICAN PSYCHOLOGICAL CORPORATION, INC.

Practice address

4712 Admiralty Way Ste 591
Marina del Rey, CA 90292-6905

Phone

(310) 850-1699

Fax

(760) 859-3877

NPI assigned

Jan 29, 2018

Organization subpart

No

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

Authorized official

Name

Elena Balashova-Shamis, PSYD

Title

President/ Owner

Phone

(310) 486-0404

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1053819672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12212",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902953212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY STE 591",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-850-1699",
            "fax_number": "760-859-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN PSYCHOLOGICAL CORPORATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "BALASHOVA-SHAMIS",
        "authorized_official_first_name": "ELENA",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "310-486-0404",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.