Active NPI
Lila Coulter, PH.D.
- Psychologist
- Berkeley, CA
National Provider Identifier
1588706162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY11391
- Practice address
- 2340 Ward St
Suite #105
Berkeley, CA 94705-1124 - Phone
- (510) 649-0207
- NPI assigned
- Feb 12, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY11391 | CA | Primary |
Addresses
Primary practice location
2340 Ward St
Suite #105
Berkeley, CA 94705-1124
Mailing address
2340 Ward St
Suite #105
Berkeley, CA 94705-1124
Phone (510) 649-0207
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2022 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY11391 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588706162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2340 WARD ST",
"address_2": "SUITE #105",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051124",
"telephone_number": "510-649-0207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2340 WARD ST",
"address_2": "SUITE #105",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051124",
"telephone_number": "510-649-0207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COULTER",
"first_name": "LILA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY11391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.