Individual provider Active NPI

Susan Lagasse, PH.D.

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1164461836
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12670 Issued in CA
Practice address
12625 High Bluff Dr
San Diego, CA 92130-2052
Phone
(858) 793-8768
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 PSY12670 CA Primary

Addresses

Primary practice location

12625 High Bluff Dr
San Diego, CA 92130-2052

Mailing address

12625 High Bluff Dr
San Diego, CA 92130-2052
Phone (858) 793-8768

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060810000522 CA Practitioner - Clinical Psychologist 4688677743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lagasse Yates IncGroup PAC ID 2668476086, 2 clinicians

Practice addresses (Care Compare)

12625 High Bluff Dr
Suite 206
San Diego, CA 92130-2053
Phone (858) 793-8768

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY12670CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lagasse Yates, Inc Clinical CurrentSince Apr 17, 2001 Accepting new patients

Locations

12625 High Bluff Dr
Ste 206
San Diego, CA 92130
Phone (619) 654-4392

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164461836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302052",
            "telephone_number": "858-793-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HIGH BLUFF DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302052",
            "telephone_number": "858-793-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGASSE",
        "first_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.