Active NPI
Diane M Lewis, PH.D.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1477784361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY27611
- Practice address
- 2035 Westwood Blvd
Suite #206
Los Angeles, CA 90025-6332 - Phone
- (626) 390-7272
- NPI assigned
- Jul 27, 2009
- Sex
- Female
- 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 | PSY27611 | CA | Primary |
Addresses
Primary practice location
2035 Westwood Blvd
Suite #206
Los Angeles, CA 90025-6332
Mailing address
1613 Chelsea Rd # 278
San Marino, CA 91108-2419
Phone (818) 292-0543
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY27611 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442966400000",
"number": "1477784361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1613 CHELSEA RD # 278",
"city": "SAN MARINO",
"state": "CA",
"postal_code": "911082419",
"telephone_number": "818-292-0543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2035 WESTWOOD BLVD",
"address_2": "SUITE #206",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900256332",
"telephone_number": "626-390-7272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "DIANE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-27",
"last_updated": "2015-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY27611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.