Active NPI
Colette Lord, PH.D.
- Clinical Psychologist
- Del Mar, CA
National Provider Identifier
1184790933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 21497
- Practice address
- 317 14TH St Ste E
Del Mar, CA 92014-2554 - Phone
- (858) 276-8831
- Fax
- (858) 215-5459
- NPI assigned
- Nov 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 21497 | CA | |
| Clinical Psychologist | 103TC0700X | 21497 | CA | Primary |
Addresses
Primary practice location
317 14TH St Ste E
Del Mar, CA 92014-2554
Mailing address
317 14TH St Ste E
Del Mar, CA 92014-2554
Phone (858) 276-8831
Other names 1
- Colette Poehling
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 21497 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1184790933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "317 14TH ST STE E",
"city": "DEL MAR",
"state": "CA",
"postal_code": "920142554",
"telephone_number": "858-276-8831",
"fax_number": "858-215-5459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 14TH ST STE E",
"city": "DEL MAR",
"state": "CA",
"postal_code": "920142554",
"telephone_number": "858-276-8831",
"fax_number": "858-215-5459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORD",
"first_name": "COLETTE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-24",
"last_updated": "2025-05-13",
"certification_date": "2025-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 21497",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "21497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "COLETTE",
"last_name": "POEHLING",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Del Mar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.