Individual provider Active NPI

Lisa Golden Balfus, ED.D.

  • Psychologist
  • Santa Monica, CA
National Provider Identifier
1649588088
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY12834 Issued in CA
Practice address
1460 7TH St
Suite 206
Santa Monica, CA 90401-2629
Phone
(310) 383-5584
NPI assigned
Sep 20, 2010
Last updated
Sep 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY12834 CA Primary

Addresses

Primary practice location

1460 7TH St
Suite 206
Santa Monica, CA 90401-2629

Mailing address

2329 26TH St
Santa Monica, CA 90405-1903
Phone (310) 383-5584

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041220000553 CA Practitioner - Clinical Psychologist 8426015694 Practice locations: Santa Monica, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2329 26TH St
Santa Monica, CA 90405-1903
Phone (310) 383-5584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY12834CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1649588088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 26TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051903",
            "telephone_number": "310-383-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 7TH ST",
            "address_2": "SUITE 206",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012629",
            "telephone_number": "310-383-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALFUS",
        "first_name": "LISA",
        "middle_name": "GOLDEN",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY12834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.