Active NPI
Lisa De la Rue, PH.D.
- Psychologist
- San Francisco, CA
National Provider Identifier
1609901446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35884
- Practice address
- 2350 Turk Blvd
San Francisco, CA 94118-4340 - Phone
- (669) 295-5411
- NPI assigned
- Feb 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 94026472 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychologist | 103T00000X | 35884 | CA | Primary |
| Counselor | 101Y00000X |
Addresses
Primary practice location
2350 Turk Blvd
San Francisco, CA 94118-4340
Mailing address
2130 Fulton St
San Francisco, CA 94117-1080
Phone (669) 295-5411
Other practice location 1
2130 Fulton St
San Francisco, CA 94117-1050
Phone (415) 422-2516
Other practice location 2
902 S Myrtle Ave
second Floor
Monrovia, CA 91016-3427
Phone (626) 357-3258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94026472 | CA | MD | Counseling Psychologist |
| 35884 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748563200000",
"number": "1609901446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2130 FULTON ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941171080",
"telephone_number": "669-295-5411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 TURK BLVD",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941184340",
"telephone_number": "669-295-5411"
}
],
"practiceLocations": [
{
"address_1": "2130 Fulton St",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941171050",
"country_code": "US",
"telephone_number": "415-422-2516",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "902 S Myrtle Ave",
"address_2": "second Floor",
"address_purpose": "LOCATION",
"city": "Monrovia",
"state": "CA",
"postal_code": "910163427",
"country_code": "US",
"telephone_number": "626-357-3258",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DE LA RUE",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2025-05-30",
"certification_date": "2025-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "94026472",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "35884",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.