Individual provider Active NPI

Lavinia Fiorentino, PHD

  • Clinical Psychologist
  • La Jolla, CA
National Provider Identifier
1376800771
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
24272 Issued in CA
Practice address
3855 Health Sciences Dr # 658
Suite 3086
La Jolla, CA 92093-1503
Phone
(858) 822-5240
Fax
(858) 822-3449
NPI assigned
Apr 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2017

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 24272 CA Primary

Addresses

Primary practice location

3855 Health Sciences Dr # 658
Suite 3086
La Jolla, CA 92093-1503

Mailing address

PO Box 232410
San Diego, CA 92193-2410
Phone (858) 249-6748

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
I20120529000268 CA Practitioner - Clinical Psychologist 6103089214 Reassigns benefits to 1 organization
Practice locations: San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12485 Ruette Alliante
San Diego, CA 92130-3502

5405 Morehouse Dr
Suite 120
San Diego, CA 92121-4723
Phone (858) 220-0226

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Apr 21, 2012 Accepting new patients
Regents of the University of California Clinical CurrentSince Apr 21, 2012 Accepting new patients

Locations

3855 Health Sciences Dr
Ste 3086
La Jolla, CA 92093
Phone (858) 822-5240

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1376800771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410",
            "telephone_number": "858-249-6748",
            "fax_number": "619-543-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 HEALTH SCIENCES DR # 658",
            "address_2": "SUITE 3086",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920931503",
            "telephone_number": "858-822-5240",
            "fax_number": "858-822-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORENTINO",
        "first_name": "LAVINIA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-23",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "24272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.