Individual provider Active NPI

Lisa Paulette Stiller, PH.D.

  • Psychologist
  • Santa Monica, CA
National Provider Identifier
1134499247
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY13304 Issued in CA
Practice address
1751 Cloverfield Blvd
Santa Monica, CA 90404-4007
Phone
(310) 450-0650
NPI assigned
Jan 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY13304 CA Primary

Addresses

Primary practice location

1751 Cloverfield Blvd
Santa Monica, CA 90404-4007

Mailing address

1751 Cloverfield Blvd
Santa Monica, CA 90404-4007
Phone (310) 450-0650

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13304CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1134499247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 CLOVERFIELD BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904044007",
            "telephone_number": "310-450-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 CLOVERFIELD BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904044007",
            "telephone_number": "310-450-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLER",
        "first_name": "LISA",
        "middle_name": "PAULETTE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY13304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.