Dynamic Psychotherapy Center Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DYNAMIC PSYCHOTHERAPY CENTER INC

Practice address

24520 Hawthorne Blvd Ste 208
Torrance, CA 90505-6843

Phone

(562) 584-7715

NPI assigned

Oct 26, 2021

Organization subpart

No

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

Authorized official

Name

Valeria M Krocak, PSYDNPI 1649619180

Title

Owner

Phone

(562) 584-7715

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 4

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

• Valeria Muradov Krocak, PSY.D.

  • Clinical Psychologist
  • Thousand Oaks, CA
  • NPI 1649619180
  Medicare reassignment NPD Authorized official
• Shabnam Sasha Kassai, PSY.D.

  • Clinical Psychologist
  • Newport Beach, CA
  • NPI 1457887895
  NPD
• Fernanda Michelle Mayorga, LMFT

  • Marriage & Family Therapist
  • Vallejo, CA
  • NPI 1992416143
  NPD
• Candice Diane Peterson

  • Mental Health Counselor
  • Vallejo, CA
  • NPI 1992956379
  NPD

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1811651797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24520 HAWTHORNE BLVD STE 208",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056843",
            "telephone_number": "562-584-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24520 HAWTHORNE BLVD STE 208",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056843",
            "telephone_number": "562-584-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PSYCHOTHERAPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "KROCAK",
        "authorized_official_first_name": "VALERIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-584-7715",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Dvorak
• Olivia Ruth Dwight, PT, DPT
• Ryan Dwyer, MD
• Ryan Dy
• Sophia Alecia Dyer
• Dynamics Orthotics & Prosthetics, Inc.
• E & a Home Health Care
• E Mac Care Services Inc.
• E.C. Lobo-Marwah, DDS., Inc
• E.M.a.G. Home Health Inc

• Clinical Psychologist in Torrance, CA
• Providers in Torrance, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.