Individual provider Active NPI

Lily M Rich, PSY.D

  • Counseling Psychologist
  • Santa Cruz, CA
National Provider Identifier
1033344015
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PSY25638 Issued in CA
Practice address
648 Western Dr
Santa Cruz, CA 95060-3058
Phone
(831) 325-8838
NPI assigned
May 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY25638 CA Primary

Addresses

Primary practice location

648 Western Dr
Santa Cruz, CA 95060-3058

Mailing address

648 Western Dr
Santa Cruz, CA 95060-3058
Phone (831) 325-8838

Other identifiers 1

IdentifierTypeStateIssuer
NO NUMBEROtherCAPRE-DOCTORAL INTERN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130821000837 CA Practitioner - Clinical Psychologist 7719120872 Practice locations: Santa Cruz, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

648 Western Dr
Santa Cruz, CA 95060-3058
Phone (831) 325-8838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY25638CAMDCounseling Psychologist
25638CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1033344015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 WESTERN DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603058",
            "telephone_number": "831-325-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 WESTERN DR",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950603058",
            "telephone_number": "831-325-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "LILY",
        "middle_name": "M",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY25638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRE-DOCTORAL INTERN",
            "identifier": "NO NUMBER",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.