Active NPI
Lucindra Campbell, PHD
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1164526190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 606088
- Practice address
- 4715 Viewridge Ave Ste 230
San Diego, CA 92123-1680 - Phone
- (800) 257-8715
- Fax
- (800) 819-1655
- NPI assigned
- Sep 11, 2006
- 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 | 606088 | TX | Primary |
Addresses
Primary practice location
4715 Viewridge Ave Ste 230
San Diego, CA 92123-1680
Mailing address
4115 Woodlake LN
Missouri City, TX 77459-4331
Phone (281) 704-2601
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8N7219 | Other | TX | BCBS |
| 062573304 | Medicaid | TX |
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
- Nurse Practitioner, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 606088 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164526190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4115 WOODLAKE LN",
"city": "MISSOURI CITY",
"state": "TX",
"postal_code": "774594331",
"telephone_number": "281-704-2601",
"fax_number": "281-649-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4715 VIEWRIDGE AVE STE 230",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231680",
"telephone_number": "800-257-8715",
"fax_number": "800-819-1655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "LUCINDRA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "606088",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8N7219",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "062573304",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.