Individual provider Active NPI

Lynn C Siegel, PSY.D.

  • Clinical Psychologist
  • Calabasas, CA
National Provider Identifier
1063507713
Registry record updated Oct 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 15371 Issued in CA
Practice address
22231 Mulholland Hwy Ste 106
Calabasas, CA 91302-5178
Phone
(818) 222-9300
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.004866 IL
Clinical Psychologist 103TC0700X PSY 15371 CA Primary

Addresses

Primary practice location

22231 Mulholland Hwy Ste 106
Calabasas, CA 91302-5178

Mailing address

PO Box 5684
Oxnard, CA 93031-5684
Phone (310) 268-2538

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
I20121113000772 CA Practitioner - Clinical Psychologist 2567613813 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22231 Mulholland Hwy
Suite 106
Calabasas, CA 91302-5178
Phone 81822293000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 15371CAMDClinical Psychologist
071.004866ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Sep 22, 2012 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Act-Associates in Clinical Therapy, a Psychological Corporation Clinical CurrentSince Jul 9, 2022 Accepting new patients
Wood Glen Hall, Inc. Past Accepting new patients

Locations

22231 Mulholland Hwy
Ste 106
Calabasas, CA 91302
Phone (818) 222-9300

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

11303 W Washington Blvd
#200
Los Angeles, CA 90066
Phone (310) 482-3200

23501 Cinema Dr
Ste 200
Valencia, CA 91355
Phone (661) 288-4800

Organizations & group practices 5

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602374400000",
    "number": "1063507713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5684",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930315684",
            "telephone_number": "310-268-2538",
            "fax_number": "310-235-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22231 MULHOLLAND HWY STE 106",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913025178",
            "telephone_number": "818-222-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "LYNN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-10-11",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.004866",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 15371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

Verify at the official NPI Registry.