Ginny Liwanpo, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 20910 Issued in CA

Practice address

1101 Dove St
#155
Newport Beach, CA 92660-2839

Phone

(949) 491-6135

Fax

(714) 362-8783

NPI assigned

Jan 26, 2010

Last updated

Jan 21, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1467783738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 DOVE ST",
            "address_2": "#155",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602839",
            "telephone_number": "949-491-6135",
            "fax_number": "714-362-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 DOVE ST",
            "address_2": "#155",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602839",
            "telephone_number": "949-491-6135",
            "fax_number": "714-362-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIWANPO",
        "first_name": "GINNY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20910",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY 20910",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY 20910",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Newport Beach, CA
• Providers in Newport Beach, 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 21, 2015; 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.