Active NPI
Mara Tolene Thorsen, PH.D.
- Psychologist
- Los Angeles, CA
National Provider Identifier
1346529328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY27944
- Practice address
- 3200 Motor Ave
Los Angeles, CA 90034-3710 - Phone
- (310) 836-1223
- NPI assigned
- Aug 9, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY27944 | CA | Primary |
Addresses
Primary practice location
3200 Motor Ave
Los Angeles, CA 90034-3710
Mailing address
3200 Motor Ave
Los Angeles, CA 90034-3710
Phone (310) 836-1223
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250321001227 | CA | Practitioner - Clinical Psychologist | 1254851686 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY27944 | CA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrative Psychology Associates, Inc. | Current | Accepting new patients | |
| Leslie Cox Emdr & Therapy Inc. | Past | Accepting new patients | |
| Pacific Coast Psychiatric Associates Inc | Past | Accepting new patients |
Locations
2522 Chambers Rd
Ste 124
Tustin, CA 92780
Phone (310) 694-1561
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.
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- NPI 1255979985
-
- Clinical Psychologist
- Scottsdale, AZ
- NPI 1023125465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1346529328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 MOTOR AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900343710",
"telephone_number": "310-836-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 MOTOR AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900343710",
"telephone_number": "310-836-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORSEN",
"first_name": "MARA",
"middle_name": "TOLENE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-09",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY27944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.