Individual provider Active NPI

Lucy Ndego Jite-Ogbuehi, PSY.D.

  • Clinical Psychologist
  • Sacramento, CA
National Provider Identifier
1225197338
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY33392 Issued in CA
Practice address
100 Howe Ave Ste 170N
Sacramento, CA 95825-8241
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY33392 CA
Clinical Psychologist 103TC0700X PSY33392 CA Primary

Addresses

Primary practice location

100 Howe Ave Ste 170N
Sacramento, CA 95825-8241

Mailing address

100 Howe Ave Ste 170N
Sacramento, CA 95825-8241
Phone (925) 282-1778

Other practice location 1

4001 State Hwy 104
Ione, CA 95640-3069
Phone (209) 274-4911 ext. 6034

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
I20241029000869 CA Practitioner - Clinical Psychologist 1355874470 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY33392CAMDClinical Psychologist
33392CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Sep 23, 2024 Accepting new patients

Locations

1480 64th St
Ste 150
Emeryville, CA 94608
Phone (415) 296-5292

2365 Iron Point Rd
Ste 210
Folsom, CA 95630
Phone (925) 360-5264

100 Howe Ave
Ste 170N
Sacramento, CA 95825
Phone (415) 296-5100

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1225197338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOWE AVE STE 170N",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958258241",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOWE AVE STE 170N",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958258241",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 State Hwy 104",
            "address_purpose": "LOCATION",
            "city": "Ione",
            "state": "CA",
            "postal_code": "956403069",
            "country_code": "US",
            "telephone_number": "209-274-4911 x6034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JITE-OGBUEHI",
        "first_name": "LUCY",
        "middle_name": "NDEGO",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY33392",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY33392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.