Traci Critton Mastandrea, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

205 Avenue I Ste 19
Redondo Beach, CA 90277-5619

Phone

(310) 980-7162

NPI assigned

Feb 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1831234277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 AVENUE I STE 19",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775619",
            "telephone_number": "310-980-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 AVENUE I STE 19",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775619",
            "telephone_number": "310-980-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTANDREA",
        "first_name": "TRACI",
        "middle_name": "CRITTON",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leila Lynne Martinez
• Nieves Milagros Martinez
• Patricia Anna Martucci, MFTI
• Jennifer Faith Marzan, PA-C
• Jessica Mason, CCC-SLP
• Richard D. Masuoka, DMD
• Mathew Deville Chiropractic, P.C.
• Rand Taylor Light Matsumoto
• Stanford Kei Matsuno, MD
• Brynn Matsuura, DDS

• Clinical Child & Adolescent Psychologist in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Clinical Child & Adolescent Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.