Glenn Psychiatric Medical Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

GLENN PSYCHIATRIC MEDICAL CORPORATION

Practice address

2200 Pacific Coast Hwy Ste 103
Hermosa Beach, CA 90254-2700

Phone

(424) 728-5564

Fax

(424) 377-6548

NPI assigned

Nov 12, 2025

Organization subpart

No

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

Authorized official

Name

Dyana Ko, NP

Title

Vice President

Phone

(424) 728-5564

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1952261968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PACIFIC COAST HWY STE 103",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542700",
            "telephone_number": "424-728-5564",
            "fax_number": "424-377-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PACIFIC COAST HWY STE 103",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542700",
            "telephone_number": "424-728-5564",
            "fax_number": "424-377-6548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN PSYCHIATRIC MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "DYANA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "424-728-5564",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Gilbert-Lurie
• Stephanie Gilmore, PT, DPT
• Diana Gilster
• Cassandra Giornali Sorrell, PSYD, LMFT
• Shari Mowlavi Giti, PSY.D.
• Kim Lauren Glenn, LMFT
• Diane Naomi Glick, LCSW
• Ron Goren Glick, PSY.D
• Theresa Rose Goldstein, MA, APCC
• Adriana Gomez

• Psychiatry Physician in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; 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.