Individual provider Active NPI

Lideth Ortega-Villalobos, PH.D.

  • Psychologist
  • Pasadena, CA
National Provider Identifier
1649644980
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY23640 Issued in CA
Practice address
1250 E Walnut St Ste 110
Pasadena, CA 91106-1877
Phone
(626) 470-3344
NPI assigned
Nov 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY23640 CA Primary

Addresses

Primary practice location

1250 E Walnut St Ste 110
Pasadena, CA 91106-1877

Mailing address

1250 E Walnut St Ste 110
Pasadena, CA 91106-1877
Phone (626) 470-3344

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

LicenseStateTypeSpecialty
PSY23640CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1649644980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E WALNUT ST STE 110",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061877",
            "telephone_number": "626-470-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E WALNUT ST STE 110",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061877",
            "telephone_number": "626-470-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA-VILLALOBOS",
        "first_name": "LIDETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY23640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.