NPIMap

Individual provider Active NPI

Laura K Pedigo, PSYD

  • Psychologist
  • La Mirada, CA
National Provider Identifier
1164669396
Registry record updated Jan 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
95-0549600 Issued in CA
Practice address
12625 La Mirada Blvd
Suite 202
La Mirada, CA 90639-0001
Phone
(562) 903-4800
Fax
(562) 903-4802
NPI assigned
Jan 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 95-0549600 CA Primary

Addresses

Primary practice location

12625 La Mirada Blvd
Suite 202
La Mirada, CA 90639-0001

Mailing address

12625 La Mirada Blvd
Suite 202
La Mirada, CA 90639-0001
Phone (562) 903-4800

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

Practice roles

OrganizationSpecialtyStatusNew patients
Biola Counseling Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1164669396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 LA MIRADA BLVD",
            "address_2": "SUITE 202",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906390001",
            "telephone_number": "562-903-4800",
            "fax_number": "562-903-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 LA MIRADA BLVD",
            "address_2": "SUITE 202",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906390001",
            "telephone_number": "562-903-4800",
            "fax_number": "562-903-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDIGO",
        "first_name": "LAURA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-09",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "95-0549600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; 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.