Individual provider Active NPI

Lori Tracie Williams, PSY.D.

  • Psychologist
  • Northridge, CA
National Provider Identifier
1093023079
Registry record updated Jun 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY29519 Issued in CA
Practice address
9227 Reseda Blvd # 131
Northridge, CA 91324-3137
Phone
(310) 853-3629
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY29519 CA Primary

Addresses

Primary practice location

9227 Reseda Blvd # 131
Northridge, CA 91324-3137

Mailing address

9227 Reseda Blvd # 131
Northridge, CA 91324-3137
Phone (310) 853-3629

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
I20201027002532 CA Practitioner - Clinical Psychologist 7315357621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Santa Monica Therapy a Psychology CorporationGroup PAC ID 7012258346, 2 clinicians

Practice addresses (Care Compare)

3301 Ocean Park Blvd
Suite 210
Santa Monica, CA 90405-3230
Phone (310) 845-6720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Monica Therapy, a Psychology Corporation CurrentSince Sep 21, 2020 Accepting new patients

Locations

3301 Ocean Park Blvd
Ste 210
Santa Monica, CA 90405
Phone (310) 845-6720

Organizations & group practices 1

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": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1093023079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9227 RESEDA BLVD # 131",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243137",
            "telephone_number": "310-853-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9227 RESEDA BLVD # 131",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243137",
            "telephone_number": "310-853-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LORI",
        "middle_name": "TRACIE",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY29519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.