Individual provider Active NPI

Erin Leigh Dornan-Liuzzo, PSY.D.

  • Clinical Psychologist
  • Costa Mesa, CA
National Provider Identifier
1386772663
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
23256 Issued in CA
Practice address
3151 Airway Ave Ste A2
Costa Mesa, CA 92626-4620
Phone
(949) 345-1186
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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 23256 CA Primary

Addresses

Primary practice location

3151 Airway Ave Ste A2
Costa Mesa, CA 92626-4620

Mailing address

18627 Brookhurst St # 194
Fountain Valley, CA 92708-6748
Phone (949) 345-1186

Other practice location 1

18627 Brookhurst St # 194
Fountain Valley, CA 92708-6748
Phone (626) 233-1923

Other names 1

  • Dr. Erin Leigh Dornan Former name

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1386772663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18627 BROOKHURST ST # 194",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086748",
            "telephone_number": "949-345-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3151 AIRWAY AVE STE A2",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264620",
            "telephone_number": "949-345-1186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18627 Brookhurst St # 194",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927086748",
            "country_code": "US",
            "telephone_number": "626-233-1923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORNAN-LIUZZO",
        "first_name": "ERIN",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "23256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "DORNAN",
            "middle_name": "LEIGH",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.