Medria Lou Connolly, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PSY9977 Issued in CA

Practice address

2444 Wilshire Blvd
Suite 500
Santa Monica, CA 90403-5808

Phone

(310) 264-2602

Fax

(310) 264-2601

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 16, 2019 through Dec 16, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1164540316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2444 WILSHIRE BLVD",
            "address_2": "SUITE 500",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035808",
            "telephone_number": "310-264-2602",
            "fax_number": "310-264-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2444 WILSHIRE BLVD",
            "address_2": "SUITE 500",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035808",
            "telephone_number": "310-264-2602",
            "fax_number": "310-264-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "MEDRIA",
        "middle_name": "LOU",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9977",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY9977",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY9977",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne April Iolanda Conn, MD
• Ashley Conner, PSYD
• Kevin Conner
• Deva M Connett
• Lynn Shapiro Connolly, M.D.
• Eimy March Connor, PA-C
• Conor Fowler MD, Inc.
• Corina Constantin-Marconi, PH.D.
• Constantine Elisseev
• Ekaterini Constantine

• Clinical Child & Adolescent Psychologist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.