Healthcare Provider Details

I. General information

NPI: 1205714284
Provider Name (Legal Business Name): ALLISON K SKOKOS ED.S PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4760 HACKETT AVE
LAKEWOOD CA
90713-2424
US

IV. Provider business mailing address

250 PACIFIC AVE APT 629
LONG BEACH CA
90802-3068
US

V. Phone/Fax

Practice location:
  • Phone: 562-420-7552
  • Fax:
Mailing address:
  • Phone: 626-217-4824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: