Individual provider Active NPI

Lina Kogan-Sbarbaro, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1003105784
Registry record updated May 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY31866 Issued in CA
Practice address
1050 University Ave Ste E107
San Diego, CA 92103-3359
Phone
(858) 504-7743
Fax
(858) 216-1928
NPI assigned
Apr 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY31866 CA Primary

Addresses

Primary practice location

1050 University Ave Ste E107
San Diego, CA 92103-3359

Mailing address

1050 University Ave Ste E107
San Diego, CA 92103-3359
Phone (858) 504-7743

Other names 1

  • Dr. Lina Kogan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY31866CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Solace Psychology Inc Clinical Current Accepting new patients
Community Research Foundation Inc Clinical Past Accepting new patients
Community Research Foundation Inc Past Accepting new patients

Locations

864 Grand Ave
San Diego, CA 92109
Phone (619) 341-9007

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651968000000",
    "number": "1003105784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 UNIVERSITY AVE STE E107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033359",
            "telephone_number": "858-504-7743",
            "fax_number": "858-216-1928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 UNIVERSITY AVE STE E107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033359",
            "telephone_number": "858-504-7743",
            "fax_number": "858-216-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN-SBARBARO",
        "first_name": "LINA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY31866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINA",
            "last_name": "KOGAN",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.