Active NPI
Regina Lazarovich, PHD
- Clinical Psychologist
- Scotts Valley, CA
National Provider Identifier
1023425519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 31508
- Practice address
- 316E Mount Hermon Rd
Scotts Valley, CA 95066-4009 - Phone
- (347) 735-9740
- NPI assigned
- Jul 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 020676 | NY | |
| Clinical Psychologist | 103TC0700X | 31508 | CA | Primary |
Addresses
Primary practice location
316E Mount Hermon Rd
Scotts Valley, CA 95066-4009
Mailing address
216E Mount Hermon Rd # 316
Scotts Valley, CA 95066-4009
Phone (347) 735-9740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020676 | NY | MD | Clinical Psychologist |
| 31508 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1023425519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216E MOUNT HERMON RD # 316",
"city": "SCOTTS VALLEY",
"state": "CA",
"postal_code": "950664009",
"telephone_number": "347-735-9740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316E MOUNT HERMON RD",
"city": "SCOTTS VALLEY",
"state": "CA",
"postal_code": "950664009",
"telephone_number": "347-735-9740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZAROVICH",
"first_name": "REGINA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-16",
"last_updated": "2023-05-23",
"certification_date": "2023-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "020676",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "31508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scotts Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.