Active NPI
Lisa Marie Lliteras, PSYD
- Psychologist
- Ontario, CA
National Provider Identifier
1275790602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 30725
- Practice address
- 855 N Euclid Ave
Ontario, CA 91762-2762 - Phone
- (909) 983-2020
- Fax
- (909) 983-6847
- NPI assigned
- May 22, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | 30725 | CA | Primary |
Addresses
Primary practice location
855 N Euclid Ave
Ontario, CA 91762-2762
Mailing address
855 N Euclid Ave
Ontario, CA 91762-2762
Phone (909) 983-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95-1946482 | Medicaid | CA |
Other names 1
- Ms. Lisa Marie Brandt
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1275790602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 N EUCLID AVE",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917622762",
"telephone_number": "909-983-2020",
"fax_number": "909-983-6847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 N EUCLID AVE",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917622762",
"telephone_number": "909-983-2020",
"fax_number": "909-983-6847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LLITERAS",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-22",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "30725",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95-1946482",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "BRANDT",
"middle_name": "MARIE",
"prefix": "MS.",
"credential": "BA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.