Individual provider Active NPI

Lori A. Futterman, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1154354611
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY8636 Issued in CA
Practice address
591 Camino de la Reina Ste 705
San Diego, CA 92108-3109
Phone
(619) 297-3311
Fax
(619) 294-3322
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY8636 CA Primary

Addresses

Primary practice location

591 Camino de la Reina Ste 705
San Diego, CA 92108-3109

Mailing address

591 Camino de la Reina Ste 705
San Diego, CA 92108-3109
Phone (619) 297-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 1, 2019 through Jan 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY8636CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154354611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 CAMINO DE LA REINA STE 705",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083109",
            "telephone_number": "619-297-3311",
            "fax_number": "619-294-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 CAMINO DE LA REINA STE 705",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083109",
            "telephone_number": "619-297-3311",
            "fax_number": "619-294-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUTTERMAN",
        "first_name": "LORI",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY8636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.