DR. MEDRIA LOU CONNOLLY PH.D.
NPI 1164540316
Psychologist - Clinical Child & Adolescent in Santa Monica, CA

Q: What is Medria Connolly's NPI number?

The NPI number for Medria Connolly is 1164540316. It was assigned to this individual provider in the NPPES registry on March 26, 2007.

Q: What is Medria Connolly's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Q: Is Medria Connolly enrolled in Medicare?

No. Medria Connolly has opted out of Medicare through December 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Medria Connolly was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 26, 2007Opted out of Medicare · through Dec 16, 2027

2444 WILSHIRE BLVD, SUITE 500, SANTA MONICA, CA 90403(310) 264-2602(310) 264-2601 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Medria Lou Connolly Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MEDRIA LOU CONNOLLY PH.D. (NPI 1164540316) is an individual clinical child & adolescent provider in Santa Monica, California, licensed in California (PSY9977) and active in the NPI registry since March 2007. She has opted out of Medicare through December 16, 2027.

NPPES Registry Identity

NPI1164540316

Entity TypeIndividualFemale

Primary Taxonomy103TC2200X

Provider Legal NameDR. MEDRIA LOU CONNOLLYCredential: PH.D.

Location Address2444 WILSHIRE BLVD, SUITE 500Santa Monica, CA 90403-5808

Mailing Address2444 Wilshire Blvd, Suite 500Santa Monica, CA 90403-5808 · (310) 264-2602 · Fax (310) 264-2601

Phone(310) 264-2602

Fax(310) 264-2601

Sole ProprietorNo

Enumeration DateMarch 26, 2007

Last NPPES UpdateSeptember 11, 2025

✔ NPI 1164540316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers

Taxonomy Code103TC2200X

License✔ Licensed in CA · PSY9977

Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Also ListedPsychologistTaxonomy 103T00000X · License PSY9977 (CA)

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License PSY9977 (CA)

2444 WILSHIRE BLVD, Santa Monica, CA 90403

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Medria Lou Connolly Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from December 16, 2019 through December 16, 2027.

Opt-Out Effective DateDecember 16, 2019

Opt-Out In Effect ThroughDecember 16, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY JACKSON BA

Behavior Analyst

2444 WILSHIRE BLVD
SANTA MONICA, CA 90403

Los Angeles County (646) 327-2723

DR. EMIL SOORANI M.D.

Specialist

2444 WILSHIRE BLVD, SUITE 300
SANTA MONICA, CA 90403

Los Angeles County (310) 453-2212

KADEN ELLISON

Behavior Analyst

2444 WILSHIRE BLVD
SANTA MONICA, CA 90403

Los Angeles County (646) 327-2723

DR. VERA DAVID PH.D

Psychologist

2444 WILSHIRE BLVD, SUITE 307
SANTA MONICA, CA 90403

Los Angeles County (310) 453-6588

BETH MACKENZIE MSW

Social Worker (Clinical)

2444 WILSHIRE BLVD, SUITE #400
SANTA MONICA, CA 90403

Los Angeles County (310) 998-8841

MEGAN COULTER LCSW

Social Worker (Clinical)

2444 WILSHIRE BLVD, SUITE 500
SANTA MONICA, CA 90403

Los Angeles County (310) 266-4091

DANIEL C MINTON MD

Psychiatry & Neurology (Psychiatry)

2444 WILSHIRE BLVD, SUITE 404
SANTA MONICA, CA 90403

Los Angeles County (310) 453-4672

DR RAHA SALEHINIA PSY D INC

Psychologist (Clinical)

2444 WILSHIRE BLVD
SANTA MONICA, CA 90403

Los Angeles County (310) 867-3737

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medria Connolly's NPI number?

The NPI number for Medria Connolly is 1164540316. It was assigned to this individual provider in the NPPES registry on March 26, 2007.

Where is Medria Connolly located?

Medria Connolly practices at 2444 Wilshire Blvd Suite 500, Santa Monica, CA 90403. The listed phone number is (310) 264-2602.

What is Medria Connolly's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

Is Medria Connolly enrolled in Medicare?

No. Medria Connolly has opted out of Medicare through December 16, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Medria Connolly was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.