Active NPI
Lana R. Landrum, PH.D.
- Clinical Psychologist
- Espanola, NM
National Provider Identifier
1043383805
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 758
- Practice address
- 243 Los Alamos Hwy
Espanola, NM 87532-2731 - Phone
- (505) 753-0773
- Fax
- (505) 753-0775
- NPI assigned
- Nov 17, 2006
- 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 | 758 | NM | Primary |
Addresses
Primary practice location
243 Los Alamos Hwy
Espanola, NM 87532-2731
Mailing address
243 Los Alamos Hwy
Espanola, NM 87532-2731
Phone (505) 753-0773
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63939 | Other | NM | PRESBYTERIAN HEALTH PLAN |
| NM100034 | Medicaid | NM |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 758 | NM | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043383805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "243 LOS ALAMOS HWY",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322731",
"telephone_number": "505-753-0773",
"fax_number": "505-753-0775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 LOS ALAMOS HWY",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322731",
"telephone_number": "505-753-0773",
"fax_number": "505-753-0775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRUM",
"first_name": "LANA",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NM",
"license": "758",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN HEALTH PLAN",
"identifier": "63939",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NM100034",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.