Shalise Lugo, PSYD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PSB94025910 Issued in CA

Practice address

260 Maple CT Ste 103
Ventura, CA 93003-3553

Phone

(805) 658-8402

NPI assigned

May 22, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1063204162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 FOOTHILL RD",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "930601909",
            "telephone_number": "805-290-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MAPLE CT STE 103",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033553",
            "telephone_number": "805-658-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO",
        "first_name": "SHALISE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSB94025910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor Lucas, CAODC
• Karin Lucero-Martinez, M.S.
• Andrea Marie Lucero-Ricketts, NP
• Shanna Rita Lucero, OTR/L
• Edgar A. Lueg, MD
• Jessica Rae Lugotoff, B.A.
• Alyssa Roxanne Lujan
• Abigail Anne Lukens, DO
• Lum Eye and Vision Center a Medical Corporation
• Lum Eye and Vision Center, a Medical Corporation

• Mental Health Counselor in Ventura, CA
• Providers in Ventura, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.