Individual provider Active NPI

Paula Leticia Cedillo, PSY. D.

  • Clinical Neuropsychologist
  • San Diego, CA
National Provider Identifier
1275168536
Registry record updated Oct 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY31658 Issued in CA
Practice address
9246 Lightwave Ave Ste 120
San Diego, CA 92123-6411
Phone
(800) 270-5016
Fax
(800) 680-3626
NPI assigned
Mar 6, 2020
Last updated
Oct 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychologist 103TF0200X PSY31658 CA
Psychologist 103T00000X PSY31658 CA
Clinical Neuropsychologist 103G00000X PSY31658 CA Primary

Addresses

Primary practice location

9246 Lightwave Ave Ste 120
San Diego, CA 92123-6411

Mailing address

9246 Lightwave Ave Ste 120
San Diego, CA 92123-6411
Phone (800) 270-5016

Other practice location 1

2302 Merrill Center Dr
El Centro, CA 92243-7526
Phone (800) 270-5016

Other practice location 2

1900 S State College Blvd Ste 100
Anaheim, CA 92806-6136
Phone (800) 270-5016

Other practice location 3

2600 W Magnolia Blvd
Burbank, CA 91505-3031
Phone (800) 270-5016

Other practice location 4

5885 Brockton Ave
Riverside, CA 92506-1863
Phone (800) 270-5016

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
31658CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Institutes of Health Behavioral Medicine and Medical Psychology Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792540800000",
    "number": "1275168536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9246 LIGHTWAVE AVE STE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921236411",
            "telephone_number": "800-270-5016",
            "fax_number": "800-680-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9246 LIGHTWAVE AVE STE 120",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921236411",
            "telephone_number": "800-270-5016",
            "fax_number": "800-680-3626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2302 Merrill Center Dr",
            "address_purpose": "LOCATION",
            "city": "El Centro",
            "state": "CA",
            "postal_code": "922437526",
            "country_code": "US",
            "telephone_number": "800-270-5016",
            "fax_number": "800-680-3626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 S State College Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928066136",
            "country_code": "US",
            "telephone_number": "800-270-5016",
            "fax_number": "800-680-3626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 W Magnolia Blvd",
            "address_purpose": "LOCATION",
            "city": "Burbank",
            "state": "CA",
            "postal_code": "915053031",
            "country_code": "US",
            "telephone_number": "800-270-5016",
            "fax_number": "800-680-3626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5885 Brockton Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925061863",
            "country_code": "US",
            "telephone_number": "800-270-5016",
            "fax_number": "800-680-3626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEDILLO",
        "first_name": "PAULA",
        "middle_name": "LETICIA",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY31658",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY31658",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY31658",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 21, 2026; 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.