Individual provider Active NPI

Stella Panos, PH.D.

  • Clinical Neuropsychologist
  • Santa Monica, CA
National Provider Identifier
1104252352
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY25723 Issued in CA
Practice address
720 Wilshire Blvd Ste 204
Santa Monica, CA 90401-1737
Phone
(424) 345-6377
Fax
(800) 387-6076
NPI assigned
Sep 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY25723 CA Primary
Clinical Psychologist 103TC0700X PSY25723 CA

Addresses

Primary practice location

720 Wilshire Blvd Ste 204
Santa Monica, CA 90401-1737

Mailing address

720 Wilshire Blvd Ste 204
Santa Monica, CA 90401-1737
Phone (562) 964-1906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140227000487 CA Practitioner - Clinical Psychologist 3779713375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

720 Wilshire Blvd
Suite 204
Santa Monica, CA 90401-1737
Phone (940) 241-7019

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY25723CAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Sep 7, 2018 Accepting new patients
Stella Panos PHD a Professional Psychology Corporation Clinical Neuropsychologist CurrentSince Oct 14, 2024 Accepting new patients
Saint John'S Health Clinic Past Accepting new patients

Locations

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

720 Wilshire Blvd
Ste 204
Santa Monica, CA 90401
Phone (323) 250-3905

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

1301 20th St
Ste 150
Santa Monica, CA 90404
Phone (310) 582-7641

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Interoperability endpoints

  • Direct secure messaging: stellapanosphd.stellapanos@160226.advancedmd-direct.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1104252352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WILSHIRE BLVD STE 204",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011737",
            "telephone_number": "562-964-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WILSHIRE BLVD STE 204",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011737",
            "telephone_number": "424-345-6377",
            "fax_number": "800-387-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOS",
        "first_name": "STELLA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY25723",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.