Individual provider Active NPI

Linda Williams, PHD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1336405117
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY24869 Issued in CA
Practice address
3525 Del Mar Heights Rd # 1881
San Diego, CA 92130-2199
Phone
(858) 381-3535
NPI assigned
Apr 6, 2012
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY24869 CA Primary

Addresses

Primary practice location

3525 Del Mar Heights Rd # 1881
San Diego, CA 92130-2199

Mailing address

3525 Del Mar Heights Rd # 1881
San Diego, CA 92130-2199
Phone (858) 381-3535

Other practice location 1

158 C Avenue
Coronado, CA 92118-1420
Phone (619) 435-5400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201109001815 CA Practitioner - Clinical Psychologist 5698185379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3525 Del Mar Heights Rd
Suite 1881
San Diego, CA 92130-2199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY24869CAMDClinical Psychologist
24869CAMDGeneral Practice Dentistry

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1336405117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 DEL MAR HEIGHTS RD # 1881",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302199",
            "telephone_number": "858-381-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 DEL MAR HEIGHTS RD # 1881",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302199",
            "telephone_number": "858-381-3535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "158 C AVENUE",
            "address_purpose": "LOCATION",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181420",
            "country_code": "US",
            "telephone_number": "619-435-5400",
            "fax_number": "619-435-5401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LINDA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-06",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.