Individual provider Active NPI

Georgina Ines Lamphere Sullivan, PHD

  • Clinical Psychologist
  • Rancho Cucamonga, CA
National Provider Identifier
1487633616
Registry record updated Aug 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 10649 Issued in CA
Practice address
8253 White Oak Ave
Rancho Cucamonga, CA 91730-7671
Phone
(909) 987-1997
Fax
(909) 978-0993
NPI assigned
Jan 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 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 PSY 10649 CA Primary

Addresses

Primary practice location

8253 White Oak Ave
Rancho Cucamonga, CA 91730-7671

Mailing address

8253 White Oak Ave
Rancho Cucamonga, CA 91730-7671
Phone (909) 987-1997

Other identifiers 1

IdentifierTypeStateIssuer
PSY 10649OtherCAPH.D. LICENSE

Other names 1

  • Dr. Georgina Ines Lamphere Other name

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
I20050812000614 CA Practitioner - Clinical Psychologist 0345270062 Reassigns benefits to 3 organizations
Practice locations: Rancho Cucamonga, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 10649CAMDClinical Psychologist
10649CAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Psychological Services, Inc. CurrentSince Dec 1, 2024 Accepting new patients

Locations

1550 N Park Ave
Pomona, CA 91768
Phone (909) 623-0791

10832 Laurel St
Ste 102
Rancho Cucamonga, CA 91730
Phone (909) 987-1997

954 W Foothill Blvd
Ste A
Upland, CA 91786
Phone (909) 946-4222

Organizations & group practices 2

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786233600000",
    "number": "1487633616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8253 WHITE OAK AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307671",
            "telephone_number": "909-987-1997",
            "fax_number": "909-978-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8253 WHITE OAK AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307671",
            "telephone_number": "909-987-1997",
            "fax_number": "909-978-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMPHERE SULLIVAN",
        "first_name": "GEORGINA",
        "middle_name": "INES",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2026-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 10649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PH.D. LICENSE",
            "identifier": "PSY 10649",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GEORGINA",
            "last_name": "LAMPHERE",
            "middle_name": "INES",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.