Individual provider Active NPI

Lawrence J Ledesma, PHD

  • Clinical Psychologist
  • Norwalk, CA
National Provider Identifier
1467409557
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY12355 Issued in CA
Practice address
11401 South Bloomfield Avenue
Norwalk, CA 90650
Phone
(562) 863-7011
Fax
(562) 864-4560
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY12355 CA Primary

Addresses

Primary practice location

11401 South Bloomfield Avenue
Norwalk, CA 90650

Mailing address

1600 9TH St
Room 205 Mailstop 2-3
Sacramento, CA 95814-6414
Phone (916) 654-2431

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070727000749 CA Practitioner - Clinical Psychologist 0042311557 Reassigns benefits to 1 organization
Practice locations: Huntington Beach, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16152 Beach Blvd
Suite 269
Huntington Beach, CA 92647-3864
Phone (714) 585-4572

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY12355CAMDClinical Psychologist
12355CAMDPediatric Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince May 23, 2007 Accepting new patients
Department of State Hospitals CurrentSince May 23, 2007 Accepting new patients
State of California - Department of Developmental Services Past Accepting new patients

Locations

11401 Bloomfield Ave
Norwalk, CA 90650
Phone (562) 863-7011

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467409557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH ST",
            "address_2": "ROOM 205 MAILSTOP 2-3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11401 SOUTH BLOOMFIELD AVENUE",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "90650",
            "telephone_number": "562-863-7011",
            "fax_number": "562-864-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "LAWRENCE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.