Laura M Condylis, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY27600 Issued in CA

Practice address

3871 Howe St
Oakland, CA 94611

Phone

(510) 418-3109

NPI assigned

Aug 24, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Laura Felton Former name

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

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1396978466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3871 HOWE ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94611",
            "telephone_number": "510-418-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3871 HOWE ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "94611",
            "telephone_number": "510-418-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDYLIS",
        "first_name": "LAURA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27600",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY27600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "FELTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Noel L Concepcion, MD
• Reena Jaituni Concepcion, MD
• Sadie Concepcion
• Sandra P. Conde, M.A.
• Kira Ruth Condey, OTR/L
• Confidence Club Psychology Services, Inc.
• Lamont Conley
• Tiny Veronica Conn
• Trinity Colleen Connaughton
• Connect Hearing, Inc.

• Clinical Psychologist in Oakland, CA
• Providers in Oakland, 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 6, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.