Healthcare Provider Details

I. General information

NPI: 1295947240
Provider Name (Legal Business Name): PANNELL PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 W HUNTINGTON DR STE 105
ARCADIA CA
91007-1616
US

IV. Provider business mailing address

1245 W HUNTINGTON DR STE 105
ARCADIA CA
91007-1616
US

V. Phone/Fax

Practice location:
  • Phone: 626-568-2949
  • Fax:
Mailing address:
  • Phone: 626-568-2949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPSY11827
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY11827
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY11827
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY11827
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPSY11827
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPSY11827
License Number StateCA

VIII. Authorized Official

Name: DR. PHILIP PANNELL
Title or Position: CEO
Credential: PH.D.
Phone: 626-568-2949