Individual provider Active NPI

Pean Lai

  • Psychologist
  • Rancho Cucamonga, CA
National Provider Identifier
1407037575
Registry record updated Nov 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY 17394 Issued in CA
Practice address
10722 Arrow Rte
Suite 510
Rancho Cucamonga, CA 91730-4808
Phone
(909) 786-2959
NPI assigned
Nov 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY 17394 CA Primary

Addresses

Primary practice location

10722 Arrow Rte
Suite 510
Rancho Cucamonga, CA 91730-4808

Mailing address

10722 Arrow Rte
Suite 510
Rancho Cucamonga, CA 91730-4808
Phone (909) 786-2959

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 17394CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1195257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195257600000",
    "number": "1407037575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE",
            "address_2": "SUITE 510",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304808",
            "telephone_number": "909-786-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE",
            "address_2": "SUITE 510",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304808",
            "telephone_number": "909-786-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAI",
        "first_name": "PEAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-17",
        "last_updated": "2007-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY 17394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2007; 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.