Yetta Lippman, ED. D.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PSY18169 Issued in CA

Practice address

820 Bay Ave
Suite 208
Capitola, CA 95010-2140

Phone

(831) 479-3419

NPI assigned

Oct 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083704415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 HIDDEN TERRACE CT",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950622950",
            "telephone_number": "831-479-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 BAY AVE",
            "address_2": "SUITE 208",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "950102140",
            "telephone_number": "831-479-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPMAN",
        "first_name": "YETTA",
        "name_prefix": "Dr.",
        "credential": "ED. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "PSY18169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "358833",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Capitola, CA
• Providers in Capitola, 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 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.

Verify at the official NPI Registry.