Lisa Black, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29110 Issued in CA

Practice address

740 Front St Ste 130
Santa Cruz, CA 95060-4536

Phone

(318) 295-8118

NPI assigned

May 11, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Silvi Integrative Health, Inc.

  • Clinical Psychologist
  • Santa Cruz, CA
  • NPI 1841970670
  NPD Authorized official
• The Grove Integrative Psychology Institute P C

  • Mental Health Counselor
  • Santa Cruz, CA
  • NPI 1265398499
  NPD Authorized official
• Regents of the University of California Ucsd Head and Neck Surgery

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1679509962
  NPD (past)

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1609302678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 FRONT ST STE 130",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 FRONT ST STE 130",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950604536",
            "telephone_number": "318-295-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie L. Bispo
• Jeffrey Blake Bissell
• Sondra Bitonti, LCSW
• Randi Bittner, LCSW
• Gail Rene Black, MFT
• Mary A Black, L.AC, MTCM, DIPL.O.M
• Carolyn Sue Blackman, RN, LCSW
• Sara Blackstorm Atton, DTCM
• Craig Blackwell, MD
• Rachel Blackwell

• Clinical Psychologist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.