Active NPI
Heidi La Bash, PHD
- Clinical Psychologist
- San Diego, CA
National Provider Identifier
1629810197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY32021
- Practice address
- VA San Diego Healthcare System
3350 La Jolla Village Drive (Research Service)
San Diego, CA 92161 - Phone
- (617) 877-2960
- NPI assigned
- Jun 6, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY32021 | CA | Primary |
Addresses
Primary practice location
VA San Diego Healthcare System
3350 La Jolla Village Drive (Research Service)
San Diego, CA 92161
Mailing address
VA San Diego Healthcare System
3350 La Jolla Village Drive (Research Service)
San Diego, CA 92161
Phone (617) 877-2960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY32021 | Other | CA | CALIFORNIA BOARD OF PSYCHOLOGY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY32021 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1629810197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "VA SAN DIEGO HEALTHCARE SYSTEM",
"address_2": "3350 LA JOLLA VILLAGE DRIVE (RESEARCH SERVICE)",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92161",
"telephone_number": "617-877-2960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA SAN DIEGO HEALTHCARE SYSTEM",
"address_2": "3350 LA JOLLA VILLAGE DRIVE (RESEARCH SERVICE)",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92161",
"telephone_number": "617-877-2960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LA BASH",
"first_name": "HEIDI",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-06",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY32021",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF PSYCHOLOGY",
"identifier": "PSY32021",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.