Active NPI
Lisa Susan Talbot, PH.D.
- Clinical Psychologist
- Palo Alto, CA
National Provider Identifier
1114295136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 27171
- Practice address
- 618 Hamilton Ave
Palo Alto, CA 94301 - Phone
- (650) 799-0810
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 27171 | CA | Primary |
Addresses
Primary practice location
618 Hamilton Ave
Palo Alto, CA 94301
Mailing address
622 Mountain View Ave
Mountain View, CA 94041-1943
Phone (650) 799-0810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 25, 2024 through Apr 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27171 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433116800000",
"number": "1114295136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 MOUNTAIN VIEW AVE",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940411943",
"telephone_number": "650-799-0810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 HAMILTON AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "94301",
"telephone_number": "650-799-0810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALBOT",
"first_name": "LISA",
"middle_name": "SUSAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-05",
"last_updated": "2015-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "27171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.