San Diego Neuropsychology PC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

SAN DIEGO NEUROPSYCHOLOGY PC

Practice address

4505 Manchester
Suite 206
Encinitas, CA 92024

Phone

(760) 944-9647

Fax

(760) 944-7491

NPI assigned

Jan 29, 2021

Last updated

Jan 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Anne Franklin

Title

Billing Manager

Phone

(216) 470-4677

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark McDonough, PH.D.

  • Clinical Neuropsychologist
  • Encinitas, CA
  • NPI 1427171412
  Medicare reassignment NPD
• Kathlyn A Khoukaz, PSYD

  • Rehabilitation Psychologist
  • San Marcos, CA
  • NPI 1336520550

  Clinical

  NPD (past)
• Laraine Marie Lipori, PSY.D.

  • Clinical Psychologist
  • Encinitas, CA
  • NPI 1689019630
  NPD (past)

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611878400000",
    "number": "1083205322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 MANCHESTER",
            "address_2": "SUITE 206",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-944-9647",
            "fax_number": "760-944-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 MANCHESTER",
            "address_2": "SUITE 206",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "92024",
            "telephone_number": "760-944-9647",
            "fax_number": "760-944-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO NEUROPSYCHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-13",
        "status": "A",
        "authorized_official_last_name": "FRANKLIN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "216-470-4677"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1427171412",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@sdneuro.com",
            "affiliation": "N",
            "endpointDescription": "Office Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office Email",
            "address_1": "4505 Manchester",
            "address_2": "Suite 206",
            "city": "Encinitas",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Neuropsychologist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.