Active NPI
Lavorial Salone, PHD
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1437103868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY18777
- Practice address
- 3636 4TH Ave
Ste 302
San Diego, CA 92103-4294 - Phone
- (760) 599-7085
- Fax
- (760) 599-5820
- NPI assigned
- May 20, 2006
- Last updated
- Jul 7, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY18777 | CA | Primary |
Addresses
Primary practice location
3636 4TH Ave
Ste 302
San Diego, CA 92103-4294
Mailing address
200 N El Camino Real
SPC 65
Oceanside, CA 92058-1781
Phone (760) 599-7085
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WCP18777A | Other | CA | RAILROAD |
| P00290777 | Other | CA | RAILROAD |
| PSY187770 | Medicaid | CA |
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: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
200 N El Camino Real
SPC 65
Oceanside, CA 92058-1781
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499385600000",
"number": "1437103868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 N EL CAMINO REAL",
"address_2": "SPC 65",
"city": "OCEANSIDE",
"state": "CA",
"postal_code": "920581781",
"telephone_number": "760-599-7085",
"fax_number": "760-599-5820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3636 4TH AVE",
"address_2": "STE 302",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921034294",
"telephone_number": "760-599-7085",
"fax_number": "760-599-5820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALONE",
"first_name": "LAVORIAL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2017-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY18777",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "WCP18777A",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "P00290777",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PSY187770",
"state": "CA"
}
],
"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 Jul 7, 2017; 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.