Lomibao Psychological Services PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

LOMIBAO PSYCHOLOGICAL SERVICES PC

Practice address

8788 Elk Grove Blvd
Elk Grove, CA 95624-1766

Phone

(916) 509-1415

Fax

(916) 273-9757

NPI assigned

Feb 19, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Madaline LomibaoNPI 1316472046

Title

Ceo/Clinical Psychologist

Phone

(916) 509-1415

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Madaline Lomibao, PSY.D

  • Clinical Psychologist
  • Ione, CA
  • NPI 1316472046
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1467217588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 582602",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957580044",
            "telephone_number": "916-509-1415",
            "fax_number": "916-273-9757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8788 ELK GROVE BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956241766",
            "telephone_number": "916-509-1415",
            "fax_number": "916-273-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMIBAO PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-17",
        "status": "A",
        "authorized_official_last_name": "LOMIBAO",
        "authorized_official_first_name": "MADALINE",
        "authorized_official_title_or_position": "CEO/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "916-509-1415",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincent Robert Locascio, DMD
• Connie Lokkesmoe
• Jack Marcelino Lomba, PT
• Sara Lomeli Miranda
• Kelsey Lomen, DDS
• Louie Lomibao
• Samantha N. Long-Chan, LCSW #105917
• Longs Drug Stores California LLC
• Longs Drug Stores California LLC
• Courtney Loo

• Clinical Psychologist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.