Organization Active NPI

Stella Panos PHD a Professional Psychology Corporation

  • Clinical Neuropsychologist
  • Santa Monica, CA
National Provider Identifier
1962223230
Registry record updated Oct 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
STELLA PANOS PHD A PROFESSIONAL PSYCHOLOGY CORPORATION
Practice address
720 Wilshire Blvd Ste 204
Santa Monica, CA 90401-1737
Phone
(424) 345-6377
NPI assigned
Oct 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2025

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

Authorized official

Name
Stella Panos, PHDNPI 1104252352
Title
President
Phone
(424) 345-6377

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X

Addresses

Primary practice location

720 Wilshire Blvd Ste 204
Santa Monica, CA 90401-1737

Mailing address

720 Wilshire Blvd Ste 204
Santa Monica, CA 90401-1737
Phone (424) 345-6377

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address StellaPanosPhD.StellaPanos@160226.advancedmd-direct.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241209001082 CA Part B Supplier - Clinic/Group Practice 1355877804 Receives reassigned benefits from 2 practitioners
Practice locations: Santa Monica, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: stellapanosphd.stellapanos@160226.advancedmd-direct.com

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761436800000",
    "number": "1962223230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WILSHIRE BLVD STE 204",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011737",
            "telephone_number": "424-345-6377",
            "fax_number": "800-387-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WILSHIRE BLVD STE 204",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904011737",
            "telephone_number": "424-345-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLA PANOS PHD A PROFESSIONAL PSYCHOLOGY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2025-10-26",
        "certification_date": "2025-10-26",
        "status": "A",
        "authorized_official_last_name": "PANOS",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "424-345-6377",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "StellaPanosPhD.StellaPanos@160226.advancedmd-direct.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "720 Wilshire Blvd Ste 204",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904011737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2025; 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.