Active NPI
Laura J Proctor, PHD
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1124434972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 29141
- Practice address
- 4370 La Jolla Village Dr Ste 400
Mindful Psychotherapy, Inc.
San Diego, CA 92122-1251 - Phone
- (858) 353-3345
- NPI assigned
- Jul 1, 2014
- 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 | 29141 | CA | Primary |
Addresses
Primary practice location
4370 La Jolla Village Dr Ste 400
Mindful Psychotherapy, Inc.
San Diego, CA 92122-1251
Mailing address
4370 La Jolla Village Dr Ste 400
Mindful Psychotherapy, Inc.
San Diego, CA 92122-1251
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493596800000",
"number": "1124434972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4370 LA JOLLA VILLAGE DR STE 400",
"address_2": "MINDFUL PSYCHOTHERAPY, INC.",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921221251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4370 LA JOLLA VILLAGE DR STE 400",
"address_2": "MINDFUL PSYCHOTHERAPY, INC.",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921221251",
"telephone_number": "858-353-3345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCTOR",
"first_name": "LAURA",
"middle_name": "J",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-01",
"last_updated": "2017-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "29141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
- Ann Marie T. Prochera, M.D.
- Andrea Lynn Procko, MS, PHD
- Bradley Wayne Proctor, IDC
- Christopher Proctor
- Jacob Anderson Proctor, SFIDC
- Nicole Jolene Proctor, MSW
- Prodigy Medical Service Inc
- Professional and Personal Excellence International
- Professional Imaging Services, Inc.
- Professional Management Services, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.