Sports Concussion Institute a Psychology Group Inc

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY12223 Issued in CA

Legal business name

SPORTS CONCUSSION INSTITUTE A PSYCHOLOGY GROUP INC

Practice address

5230 Pacific Concourse Dr
Suite 300
Los Angeles, CA 90045-6200

Phone

(310) 643-9595

Fax

(310) 643-5180

NPI assigned

Nov 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Tony L Strickland, P.H.D.

Title

Owner Provider

Phone

(310) 643-9595

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mari Sian Davies, PHD

  • Clinical Neuropsychologist
  • Marina del Rey, CA
  • NPI 1104198514
  NPD (past)
• Hayley Kristinsson, PSYD

  • Clinical Neuropsychologist
  • Orange, CA
  • NPI 1023500493
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483920000000",
    "number": "1194896498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 PACIFIC CONCOURSE DRIVE",
            "address_2": "SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900456200",
            "telephone_number": "310-643-9595",
            "fax_number": "310-643-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 PACIFIC CONCOURSE DR",
            "address_2": "SUITE 300",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900456200",
            "telephone_number": "310-643-9595",
            "fax_number": "310-643-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS CONCUSSION INSTITUTE A PSYCHOLOGY GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2017-01-09",
        "status": "A",
        "authorized_official_last_name": "STRICKLAND",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "310-643-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "P.H.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY12223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ50434Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daisy Spooler, MSW
• Mark J Spoonamore, M.D.
• Amanda Spooner, PSY.D.
• Kalin Spooner
• Sandee Spooner, RD
• Sports Medicine Institute - Los Angeles a Prof Physical Therapy Co
• Michael Lawrence Sporty, M.D.
• Frank Salvatore Sposato
• Spot for Kids Inc
• Spotlink Medical Supply Inc

• Clinical Neuropsychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.