NPIMap

Organization Active NPI

Lisa a Davidson, PHD, Apc

  • Clinical Psychologist
  • Poway, CA
National Provider Identifier
1548513849
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY19308 Issued in CA
Legal business name
LISA A DAVIDSON, PHD, APC
Practice address
14015 Midland Rd
Poway, CA 92064-3959
Phone
(858) 672-0130
Fax
(858) 391-0499
NPI assigned
Oct 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Authorized official

Name
Dr. Lisa A Davidson, PHDNPI 1659497600
Title
President
Phone
(858) 672-0130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X PSY19308 CA Primary

Addresses

Primary practice location

14015 Midland Rd
Poway, CA 92064-3959

Mailing address

14015 Midland Rd
Poway, CA 92064-3959
Phone (858) 672-0130

National Provider Directory

National Provider Directory

Locations

14015 Midland Rd
Poway, CA 92064
Phone (858) 672-0130

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1548513849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14015 MIDLAND RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920643959",
            "telephone_number": "858-672-0130",
            "fax_number": "858-391-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14015 MIDLAND RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920643959",
            "telephone_number": "858-672-0130",
            "fax_number": "858-391-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA A DAVIDSON, PHD, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-672-0130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY19308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.