Individual provider Active NPI

Mara Tolene Thorsen, PH.D.

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1346529328
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY27944 Issued in CA
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

Updated by the provider on Feb 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321001227 CA Practitioner - Clinical Psychologist 1254851686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY27944CAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Psychology Associates, Inc. CurrentSince Jan 4, 2025 Accepting new patients
Leslie Cox Emdr & Therapy Inc. PastSince Jul 25, 2019 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.

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

Verify at the official NPI Registry.