Individual provider Active NPI

Barbara Lynn Sanders, PSY.D.

  • Clinical Psychologist
  • Upland, CA
National Provider Identifier
1013423904
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY8288 Issued in CA
Practice address
225 N Euclid Ave
Upland, CA 91786-6038
Phone
(909) 626-5589
NPI assigned
Dec 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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 PSY8288 CA Primary

Addresses

Primary practice location

225 N Euclid Ave
Upland, CA 91786-6038

Mailing address

954 N Amelia Ave Ste B-4
San Dimas, CA 91773-1407
Phone (909) 626-5589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2013 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSY8288CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lusk Psychological Services, Inc. Clinical Current Accepting new patients

Locations

954 N Amelia Ave
Ste B4
San Dimas, CA 91773
Phone (909) 626-5589

225 N Euclid Ave
Upland, CA 91786
Phone (909) 276-7463

Organizations & group practices 1

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": "1513209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1013423904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 N AMELIA AVE STE B-4",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917731407",
            "telephone_number": "909-626-5589",
            "fax_number": "909-217-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N EUCLID AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866038",
            "telephone_number": "909-626-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "BARBARA",
        "middle_name": "LYNN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-14",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.