NPIMap

Organization Active NPI

Southern California Psychodiagnostics, LLC

  • Psychoanalysis Psychologist
  • Pasadena, CA
National Provider Identifier
1972876332
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychoanalysis PsychologistTaxonomy code 103TP0814X
Legal business name
SOUTHERN CALIFORNIA PSYCHODIAGNOSTICS, LLC
Practice address
2698 Mataro St
Pasadena, CA 91107-3416
Phone
(626) 773-3300
Fax
(626) 773-3333
NPI assigned
Feb 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Martin V Ross, PH.D.
Title
Psychologist
Phone
(626) 773-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalysis PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0814X CA Primary

Addresses

Primary practice location

2698 Mataro St
Pasadena, CA 91107-3416

Mailing address

2698 Mataro St
Pasadena, CA 91107-3416
Phone (626) 773-3300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1972876332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 MATARO ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073416",
            "telephone_number": "626-773-3300",
            "fax_number": "626-773-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 MATARO ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073416",
            "telephone_number": "626-773-3300",
            "fax_number": "626-773-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA PSYCHODIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "626-773-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TP0814X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Psychoanalysis",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.