Individual provider Active NPI

Ryan Emily Lucash, PH.D.

  • Clinical Psychologist
  • Palo Alto, CA
National Provider Identifier
1659496313
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY25960 Issued in CA
Practice address
750 Welch Rd
Developmental-Behavioral Pediatrics Office
Palo Alto, CA 94304-1507
Phone
(650) 725-8995
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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 PSY25960 CA Primary

Addresses

Primary practice location

750 Welch Rd
Developmental-Behavioral Pediatrics Office
Palo Alto, CA 94304-1507

Mailing address

750 Welch Rd
Developmental-Behavioral Pediatrics Office
Palo Alto, CA 94304-1507
Phone (650) 725-8995

Other names 1

  • Ms. Ryan Emily Fussell Former name

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY25960CAMDClinical Psychologist
25960CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1659496313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WELCH RD",
            "address_2": "DEVELOPMENTAL-BEHAVIORAL PEDIATRICS OFFICE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041507",
            "telephone_number": "650-725-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELCH RD",
            "address_2": "DEVELOPMENTAL-BEHAVIORAL PEDIATRICS OFFICE",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041507",
            "telephone_number": "650-725-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCASH",
        "first_name": "RYAN",
        "middle_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "FUSSELL",
            "middle_name": "EMILY",
            "prefix": "MS.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.