Organization Active NPI

Takos Psychology, PC

Doing business as South Coast Psychological Services

  • Psychologist
  • Newport Beach, CA
National Provider Identifier
1285154450
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
21903 Issued in CA
Legal business name
TAKOS PSYCHOLOGY, PC
Doing business as
South Coast Psychological Services
Practice address
901 Dove St Ste 150
Newport Beach, CA 92660-3018
Phone
(949) 701-7976
NPI assigned
Jun 20, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dimitra Takos, PSYD
Title
Licensed Clinical Psychologist
Phone
(949) 701-7976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 21903 CA Primary

Addresses

Primary practice location

901 Dove St Ste 150
Newport Beach, CA 92660-3018

Mailing address

901 Dove St Ste 150
Newport Beach, CA 92660-3018
Phone (949) 701-7976

Other identifiers 1

IdentifierTypeStateIssuer
1982841953MedicaidCA

Other names 1

  • South Coast Psychological Services Doing business as

National Provider Directory

National Provider Directory

Locations

901 Dove St
Ste 150
Newport Beach, CA 92660
Phone (714) 310-1670

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285154450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 DOVE ST STE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603018",
            "telephone_number": "949-701-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DOVE ST STE 150",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926603018",
            "telephone_number": "949-701-7976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKOS PSYCHOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TAKOS",
        "authorized_official_first_name": "DIMITRA",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "949-701-7976",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "21903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982841953",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Coast Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.