Individual provider Active NPI

Lenora M Poe, PHD

  • Psychologist
  • Berkeley, CA
National Provider Identifier
1013077247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
MFT20628 Issued in CA
Practice address
2034 Blake St
#1
Berkeley, CA 94704
Phone
(510) 845-7189
Fax
(510) 845-2330
NPI assigned
Dec 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X MFT20628 CA Primary

Addresses

Primary practice location

2034 Blake St
#1
Berkeley, CA 94704

Mailing address

2034 Blake St
#1
Berkeley, CA 94704
Phone (510) 845-7189

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFT20628CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013077247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 BLAKE ST",
            "address_2": "#1",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94704",
            "telephone_number": "510-845-7189",
            "fax_number": "510-845-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 BLAKE ST",
            "address_2": "#1",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94704",
            "telephone_number": "510-845-7189",
            "fax_number": "510-845-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "LENORA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "MFT20628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.