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PACIFICA NEUROPSYCHOLOGY CENTER
NPI 1962783951
Clinical Neuropsychologist in San Pedro, CA

Active since September 02, 2011
461 W 6TH ST, SUITE 211, SAN PEDRO, CA 90731(310) 547-0084(310) 833-5672 Get Directions Write a Review

NPPES record last updated: January 26, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Pacifica Neuropsychology Center NPPES

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

PACIFICA NEUROPSYCHOLOGY CENTER (NPI 1962783951) is a healthcare organization registered as a clinical neuropsychologist in San Pedro, California and active in the NPI registry since September 2011. The organization lists Marisa Mares, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1962783951
Entity TypeOrganization
Primary Taxonomy103G00000X
Legal Business NamePACIFICA NEUROPSYCHOLOGY CENTER
Location Address461 W 6TH ST, SUITE 211San Pedro, CA 90731-2694
Mailing Address461 W 6th St, Suite 211San Pedro, CA 90731-2694 · (310) 547-0084 · Fax (310) 833-5672
Phone(310) 547-0084
Fax(310) 833-5672
Organization SubpartNo
Authorized OfficialMarisa MaresClinical Director · (310) 547-0084
Enumeration DateSeptember 2, 2011
Last NPPES UpdateJanuary 26, 2017
✔ NPI 1962783951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in CA · PSY 19781
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License MFC 42200 (CA)
461 W 6TH ST, SUITE 211, San Pedro, CA 90731
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pacifica Neuropsychology Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pacifica Neuropsychology Center, which bills Medicare for the services this clinician delivers.

Clinician (1)

Marisa Mares, PH.D.
Clinical Psychologist
NPI 1033203054
461 W 6TH ST SUITE 204
San Pedro, CA 90731
(310) 547-0084
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Pacifica Neuropsychology Center's NPI number?

The NPI number for Pacifica Neuropsychology Center is 1962783951. It was assigned to this organization in the NPPES registry on September 2, 2011.

Where is Pacifica Neuropsychology Center located?

Pacifica Neuropsychology Center is located at 461 W 6th St, Suite 211, San Pedro, CA 90731. The listed phone number is (310) 547-0084.

What is Pacifica Neuropsychology Center's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Pacifica Neuropsychology Center enrolled in Medicare?

Yes. Pacifica Neuropsychology Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pacifica Neuropsychology Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Pacifica Neuropsychology Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pacifica Neuropsychology Center was last updated on January 26, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.