Individual provider Active NPI

Richard Steven Lesch, PHD

  • Clinical Psychologist
  • Petaluma, CA
National Provider Identifier
1649210691
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY#12976 Issued in CA
Practice address
222 Weller St
Petaluma, CA 94952-3183
Phone
(707) 477-8907
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY#12976 CA Primary

Addresses

Primary practice location

222 Weller St
Petaluma, CA 94952-3183

Mailing address

334 Bassett St
Petaluma, CA 94952-2512
Phone (707) 477-8907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120607000751 CA Practitioner - Psychologist Billing Independently 7113059718 Reassigns benefits to 1 organization
Practice locations: Petaluma, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

222 Weller St
Petaluma, CA 94952-3183
Phone (707) 477-8907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
12976CAMDProfessional Counselor
PSY#12976CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals CurrentSince May 23, 2007 Accepting new patients
Department of State Hospitals CurrentSince May 23, 2007 Accepting new patients
Department of State Hospitals Current Accepting new patients

Locations

2100 Napa Vallejo Hwy
Napa, CA 94558
Phone (707) 253-5000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1649210691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 BASSETT ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522512",
            "telephone_number": "707-477-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 WELLER ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523183",
            "telephone_number": "707-477-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESCH",
        "first_name": "RICHARD",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY#12976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.