Persona Psychological Group, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PERSONA PSYCHOLOGICAL GROUP, INC

Practice address

5550 Wilshire Blvd Apt 417
Los Angeles, CA 90036-4861

Phone

(562) 445-9900

NPI assigned

Jan 17, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Aglaed V Salazar, PSY.D.

Title

Owner/Clinical Psychologist

Phone

(562) 445-9900

Specialties & licenses 4

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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

• Aglaed Veronica Mayorga, PSYD

  • Forensic Psychologist
  • Los Angeles, CA
  • NPI 1609165265

  Clinical

  NPD

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1902557325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 WILSHIRE BLVD APT 417",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364861",
            "telephone_number": "562-445-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 WILSHIRE BLVD APT 417",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364861",
            "telephone_number": "562-445-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONA PSYCHOLOGICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-17",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "AGLAED",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "562-445-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8109 2nd St Ste 202",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902413666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Persky
• Dwayne Perry Persley
• Samantha Persoff
• Mary Frances Person, L.AC.
• Rachel A Person
• Personal Development Institute
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• Personalized Nutrition Counseling LLC

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.