Jeffrey Jay Lille, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY9831 Issued in CA

Practice address

1264 Higuera St
Suite 201
San Luis Obispo, CA 93401-3124

Phone

(805) 550-3162

Fax

(805) 474-1521

NPI assigned

Jun 28, 2007

Sex

Male

Sole proprietor

No

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, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1124225628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1670",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934211670",
            "telephone_number": "805-550-3162",
            "fax_number": "805-474-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 HIGUERA ST",
            "address_2": "SUITE 201",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013124",
            "telephone_number": "805-550-3162",
            "fax_number": "805-474-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLE",
        "first_name": "JEFFREY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geneva Mary Licht
• David Chris Lichti, LMFT
• Danny Leroy Lickness, MD
• Life Steps Foundation, Inc.
• Lifecare Solutions Inc
• Kai Lillie, LMFT 137200
• Limberg Eye Surgery a Medical Corporation
• Limberg Lasik Institute
• Michael Borg Limberg, M.D.
• Jireh Lin, DDS

• Clinical Psychologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.