Individual provider Active NPI

Lucille Esralew, CP

  • Clinical Neuropsychologist
  • Princeton, NJ
National Provider Identifier
1104982271
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35S100396800 Issued in NJ
Practice address
707 Alexander Rd
Suite 208
Princeton, NJ 08540-6331
Phone
(609) 419-4409
NPI assigned
Dec 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 35S100396800 NJ Primary
Clinical Psychologist 103TC0700X 35S100396800 NJ

Addresses

Primary practice location

707 Alexander Rd
Suite 208
Princeton, NJ 08540-6331

Mailing address

7F Dennison Dr
East Windsor, NJ 08520-5214
Phone (609) 443-0452

Other identifiers 1

IdentifierTypeStateIssuer
886088MedicaidNJ

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
I20200713001348 CA Practitioner - Clinical Psychologist 8325949985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellqor Psychological Services of California, PCGroup PAC ID 6103122171, 2 clinicians

Practice addresses (Care Compare)

1100 W Town and Country Rd
Suite 1250
Orange, CA 92868-4633
Phone 84488803551007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31200CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellqor Psychological Services of California, PC Clinical CurrentSince Jul 8, 2020 Accepting new patients
Spine Pain Rehab, LLC Past Accepting new patients
Darrell Broaddus Psychological Services PC Clinical Past Accepting new patients
Rehabcare Group East, LLC Past Accepting new patients
Guardian Eldercare PC Past Accepting new patients
Wellqor Psychological Services Northeast, PC Clinical Past Accepting new patients

Locations

350 Calloway Dr
Bakersfield, CA 93312
Phone (661) 587-0182

9730 Backer Ranch Rd
Elk Grove, CA 95757
Phone (833) 667-1103

3012 Bear Valley Pkwy S
Escondido, CA 92025
Phone (760) 735-8084

7545 Irvine Center Dr
Ste 200
Irvine, CA 92618
Phone (949) 503-5112

900 N Church St
Lodi, CA 95240
Phone (209) 201-2650

1100 W Town and Country Rd
Ste 1250
Orange, CA 92868
Phone (657) 339-2799

2404 Loring St
San Diego, CA 92109
Phone (858) 252-2700

980 W 7th St
San Jacinto, CA 92582
Phone (951) 654-9347

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

245 W Sierra Madre Blvd
Sierra Madre, CA 91024
Phone (626) 325-3780

25535 Hawthorne Blvd
Torrance, CA 90505

2419 N Euclid Ave
Upland, CA 91784
Phone (909) 981-4002

135 Pinelawn Rd
Ste 204N
Melville, NY 11747
Phone (631) 328-2440

Organizations & group practices 6

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": "1167436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1104982271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7F DENNISON DR",
            "city": "EAST WINDSOR",
            "state": "NJ",
            "postal_code": "085205214",
            "telephone_number": "609-443-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 ALEXANDER RD",
            "address_2": "SUITE 208",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085406331",
            "telephone_number": "609-419-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESRALEW",
        "first_name": "LUCILLE",
        "credential": "CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-30",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35S100396800",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S100396800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886088",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.