Alysia L Liddell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY19996 Issued in CA

Practice address

5931 Stanley Ave Ste 1
Carmichael, CA 95608-3846

Phone

(916) 436-3580

Fax

(916) 436-3581

NPI assigned

Jul 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Alysia Liddell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1497985410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3941 PARK DR STE 20-359",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957624549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5931 STANLEY AVE STE 1",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956083846",
            "telephone_number": "916-436-3580",
            "fax_number": "916-436-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDDELL",
        "first_name": "ALYSIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSIA",
            "last_name": "LIDDELL",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Psychologist in Carmichael, CA
• Providers in Carmichael, 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 6, 2020; 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.