Active NPI
Lisa Duhaylongsod, M.D.
- Psychiatry Physician
- San Diego, CA
National Provider Identifier
1396933818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- A92366
- Practice address
- 3853 Rosecrans St
San Diego, CA 92110-3115 - Phone
- (619) 692-8232
- NPI assigned
- Oct 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | A92366 | CA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | A92366 | CA |
Addresses
Primary practice location
3853 Rosecrans St
San Diego, CA 92110-3115
Mailing address
3853 Rosecrans St
San Diego, CA 92110-3115
Phone (619) 692-8232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A92366 | CA | MD | Child & Adolescent Psychiatry Physician |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312156800000",
"number": "1396933818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3853 ROSECRANS ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103115",
"telephone_number": "619-692-8232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3853 ROSECRANS ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921103115",
"telephone_number": "619-692-8232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUHAYLONGSOD",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-10",
"last_updated": "2011-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "A92366",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "CA",
"license": "A92366",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.