Magnolia Neuropsychology Corporation

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

MAGNOLIA NEUROPSYCHOLOGY CORPORATION

Practice address

440 E Huntington Dr Ste 300
Arcadia, CA 91006-3775

Phone

(626) 823-2799

NPI assigned

May 12, 2022

Organization subpart

No

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

Authorized official

Name

Tammy KealeyNPI 1548917800

Title

Ceo

Phone

(626) 823-2799

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

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

• Tammy Kealey, PSYD

  • Clinical Neuropsychologist
  • Arcadia, CA
  • NPI 1548917800
  Medicare reassignment NPD Authorized official
• Ashley Fabeck

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1124285077
  NPD (past)

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1831836709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E HUNTINGTON DR STE 300",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063775",
            "telephone_number": "626-823-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E HUNTINGTON DR STE 300",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910063775",
            "telephone_number": "626-823-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA NEUROPSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "KEALEY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-823-2799"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Fernanda Magana
• Alejandro Magat, D.M.D
• Maelyn Magat
• Magic Anesthesia Consultants Inc
• Alexander Maglunog Jr., M.D.
• Jayareena Mahalingam, MD
• Philip Matthew Mahoeny, DMD
• Crystal Jasmin Maldonado
• Monica Maldonado
• Rosemarrie Maldonado

• Clinical Neuropsychologist in Arcadia, CA
• Providers in Arcadia, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.