Individual provider Active NPI

Lisa L Persinger, PH.D.

  • Psychologist
  • Tucson, AZ
National Provider Identifier
1275677460
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3743 Issued in AZ
Practice address
1010 E 10TH St
Tucson, AZ 85719-5813
Phone
(520) 225-2400
NPI assigned
Feb 19, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3743 AZ Primary
Psychologist 103T00000X EDUCATOR ID 1540073 AZ

Addresses

Primary practice location

1010 E 10TH St
Tucson, AZ 85719-5813

Mailing address

PO Box 42228
Tucson, AZ 85733-2228
Phone (520) 225-2400

Other identifiers 1

IdentifierTypeStateIssuer
554875MedicaidAZ

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
EDUCATOR ID 1540073AZMDPsychologist
3743AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275677460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42228",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857332228",
            "telephone_number": "520-225-2400",
            "fax_number": "520-225-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E 10TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857195813",
            "telephone_number": "520-225-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSINGER",
        "first_name": "LISA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "3743",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "EDUCATOR ID 1540073",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "554875",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.