Active NPI
Lydia Von Imm, PHD
- Psychologist
- Carlsbad, CA
National Provider Identifier
1326168501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY12267
- Practice address
- 1902 Wright PL Ste 200
Carlsbad, CA 92008-6583 - Phone
- (760) 720-7687
- Fax
- (760) 720-7687
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY12267 | CA | Primary |
Addresses
Primary practice location
1902 Wright PL Ste 200
Carlsbad, CA 92008-6583
Mailing address
PO Box 2421
Carlsbad, CA 92018
Phone (760) 720-7687
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY12267 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301011200000",
"number": "1326168501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2421",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "92018",
"telephone_number": "760-720-7687",
"fax_number": "760-720-7687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1902 WRIGHT PL STE 200",
"city": "CARLSBAD",
"state": "CA",
"postal_code": "920086583",
"telephone_number": "760-720-7687",
"fax_number": "760-720-7687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VON IMM",
"first_name": "LYDIA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2011-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY12267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carlsbad, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.