NPIMap

Organization Active NPI

Lags Spine and Sportscare Medical Centers, Inc.

  • Addiction (Substance Use Disorder) Psychologist
  • Stockton, CA
National Provider Identifier
1255897757
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
Legal business name
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Practice address
4505 Precissi LN Ste a
Stockton, CA 95207-6240
Phone
(209) 425-3815
Fax
(209) 451-0704
NPI assigned
Feb 20, 2019
Last updated
Feb 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Amy D'Amato
Title
Contracts Manager
Phone
(805) 264-3388

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU Primary
Clinical Social Worker 1041C0700X NU
Psychiatric/Mental Health Registered Nurse 163WP0808X NU

Addresses

Primary practice location

4505 Precissi LN Ste a
Stockton, CA 95207-6240

Mailing address

218 N I St
Lompoc, CA 93436-0909
Phone (805) 736-7886

National Provider Directory

National Provider Directory
Tax ID family
Lags Spine and Sportscare Medical Centers Inc52 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4505 Precissi Ln
Ste A
Stockton, CA 95207
Phone (209) 425-3815

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1255897757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 N I ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934360909",
            "telephone_number": "805-736-7886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 PRECISSI LN STE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076240",
            "telephone_number": "209-425-3815",
            "fax_number": "209-451-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "D'AMATO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CONTRACTS MANAGER",
        "authorized_official_telephone_number": "805-264-3388"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.