Individual provider Active NPI

Lauren Michelle Perez

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1033460274
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY32695 Issued in CA
Practice address
1001 Potrero Ave
6B
San Francisco, CA 94110-3518
Phone
(415) 206-5270
NPI assigned
Sep 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Student in an Organized Health Care Education/Training Program 390200000X
Psychologist 103T00000X PSY32695 CA Primary

Addresses

Primary practice location

1001 Potrero Ave
6B
San Francisco, CA 94110-3518

Mailing address

2728 Durant Ave
Berkeley, CA 94704-1725
Phone (510) 841-9230

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
I20211122002006 CA Practitioner - Clinical Psychologist 1153710678 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY32695CAMDPsychologist
32695CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
City and County of San Francisco CurrentSince Sep 28, 2021 Accepting new patients
University of California San Francisco CurrentSince Jun 29, 2022 Accepting new patients
University of California San Francisco Current Accepting new patients
City & County of San Francisco Current Accepting new patients
UC San Francisco CurrentSince Jun 29, 2022 Accepting new patients
Wright Institute Past Accepting new patients
University of California, San Francisco Past Accepting new patients

Locations

1001 Potrero Ave
#6B
San Francisco, CA 94110
Phone (415) 206-5270

1001 Potrero Ave
Ste 6B
San Francisco, CA 94110
Phone (415) 206-4444

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Bldg 20
San Francisco, CA 94110
Phone (415) 206-8524

Organizations & group practices 7

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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1033460274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 DURANT AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041725",
            "telephone_number": "510-841-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVE",
            "address_2": "6B",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LAUREN",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-27",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY32695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.