Active NPI
Jose Marcos Lafosse, PH.D.
- Clinical Neuropsychologist
- San Diego, CA
National Provider Identifier
1306057260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 2278
- Practice address
- 4080 Centre St Ste 104
San Diego, CA 92103-2655 - Phone
- (858) 964-0722
- Fax
- (866) 437-0375
- NPI assigned
- May 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 2278 | CO | |
| Clinical Psychologist | 103TC0700X | 2278 | CO | |
| Clinical Neuropsychologist | 103G00000X | 2278 | CO | Primary |
Addresses
Primary practice location
4080 Centre St Ste 104
San Diego, CA 92103-2655
Mailing address
4251 Kipling St
Unit 565
Wheat Ridge, CO 80033-2899
Phone (720) 965-0055
Other practice location 1
4251 Kipling St
Unit 565
Wheat Ridge, CO 80033-2899
Phone (720) 965-0055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2278 | Other | CO | STATE LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659312000000",
"number": "1306057260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4251 KIPLING ST",
"address_2": "UNIT 565",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800332899",
"telephone_number": "720-965-0055",
"fax_number": "720-799-0383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4080 CENTRE ST STE 104",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032655",
"telephone_number": "858-964-0722",
"fax_number": "866-437-0375"
}
],
"practiceLocations": [
{
"address_1": "4251 KIPLING ST",
"address_2": "UNIT 565",
"address_purpose": "LOCATION",
"city": "WHEAT RIDGE",
"state": "CO",
"postal_code": "800332899",
"country_code": "US",
"telephone_number": "720-965-0055",
"fax_number": "720-799-0383",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAFOSSE",
"first_name": "JOSE",
"middle_name": "MARCOS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2022-08-01",
"certification_date": "2022-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CO",
"license": "2278",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "2278",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CO",
"license": "2278",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "2278",
"state": "CO"
}
],
"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 Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.