Healthcare Provider Details

I. General information

NPI: 1033919329
Provider Name (Legal Business Name): OFFICES OF DR MEGAN MANSFIELD, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 S LOS ROBLES AVE UNIT 202
PASADENA CA
91101-2488
US

IV. Provider business mailing address

1308 E COLORADO BLVD UNIT 3420
PASADENA CA
91106-1932
US

V. Phone/Fax

Practice location:
  • Phone: 424-278-4225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MEGAN MANSFIELD
Title or Position: CEO & CLINICAL PSYCHOLOGIST
Credential:
Phone: 917-440-4058