Active NPI
Jennifer Sara Lee-Dick, PSY.D
- Clinical Psychologist
- Sierra Madre, CA
National Provider Identifier
1013147404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSB94020558
- Practice address
- 505 W Sierra Madre Blvd
Sierra Madre, CA 91024-2364 - Phone
- (626) 539-2001
- NPI assigned
- Jul 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSB94020558 | CA | Primary |
Addresses
Primary practice location
505 W Sierra Madre Blvd
Sierra Madre, CA 91024-2364
Mailing address
505 W Sierra Madre Blvd
Sierra Madre, CA 91024-2364
Phone (626) 539-2001
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSB94020558 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402531200000",
"number": "1013147404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 W SIERRA MADRE BLVD",
"city": "SIERRA MADRE",
"state": "CA",
"postal_code": "910242364",
"telephone_number": "626-539-2001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 W SIERRA MADRE BLVD",
"city": "SIERRA MADRE",
"state": "CA",
"postal_code": "910242364",
"telephone_number": "626-539-2001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE-DICK",
"first_name": "JENNIFER",
"middle_name": "SARA",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-20",
"last_updated": "2014-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSB94020558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sierra Madre, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.