Individual
DR. MEDRIA LOU CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2444 WILSHIRE BLVD, SUITE 500, SANTA MONICA, CA 90403-5808
(310) 264-2602
(310) 264-2601
Mailing address
2444 WILSHIRE BLVD, SUITE 500, SANTA MONICA, CA 90403-5808
(310) 264-2602
(310) 264-2601
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY9977
CA
103TC0700X
Clinical Psychologist
PSY9977
CA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY9977
CA
Other
Enumeration date
03/26/2007
Last updated
09/11/2025
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