Laurie Ellen Berenson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY12568 Issued in CA

Practice address

450 S Melrose Dr Ste 113
Vista, CA 92081-6674

Phone

(760) 224-4333

Fax

(760) 301-0044

NPI assigned

Mar 6, 2007

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

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

Specialty

Clinical Psychologist

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1104956556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S MELROSE DR STE 113",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816674",
            "telephone_number": "760-224-4333",
            "fax_number": "760-301-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S MELROSE DR STE 113",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816674",
            "telephone_number": "760-224-4333",
            "fax_number": "760-301-0044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 S Melrose Dr",
            "address_2": "Suite 335",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920816641",
            "country_code": "US",
            "telephone_number": "760-224-4333",
            "fax_number": "760-301-0044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERENSON",
        "first_name": "LAURIE",
        "middle_name": "ELLEN",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Bennett, PHD
• Kiara Tavona Bennett
• Ryan Bennett, RADT 1
• William Russell Murray Bennett, MD
• Monet Benson
• Gershon H Bergeisen, M.D.
• Allyson Marie Berliner
• Jacqueline Berlo, BCABA
• Randy Beth Berman, AMFT
• Elsie Bernardo-Gregory, NP

• Clinical Psychologist in Vista, CA
• Providers in Vista, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.