Cory Marie Fitzpatrick, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY18294 Issued in CA

Practice address

2031 Howe Ave Ste 200
Sacramento, CA 95825-0178

Phone

(916) 541-4145

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Cory Marie Lazansky Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment NPD
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Vallejo, CA
  • NPI 1336222397
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1336206648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 FAIR OAKS BLVD",
            "address_2": "MENTAL HEALTH #15",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254708",
            "telephone_number": "916-480-6914",
            "fax_number": "916-480-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2031 HOWE AVE STE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958250178",
            "telephone_number": "916-541-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "CORY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY18294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2345 Fair Oaks Blvd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958254708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CORY",
            "last_name": "LAZANSKY",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Caitlyn Fitzer
• James Fitzgerald
• Jennifer Fitzgerald, NP
• Megan Elizabeth Fitzgerald, PAC
• Victoria Fitzgerald
• Ellen P Fitzpatrick, M.D.
• Ranet Fitzpatrick
• Thomas A. Fitzpatrick, MD
• Emily Fitzsimmons, RBT, BA
• Shawn Rachell Fitzsimmons

• Clinical Psychologist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.