Individual provider Active NPI

Courtney Clay Peraza

  • Counseling Psychologist
  • La Jolla, CA
National Provider Identifier
1669730388
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
9500 Gilman Dr Dept 304
La Jolla, CA 92093-0304
Phone
(858) 534-3755
NPI assigned
May 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X Primary

Addresses

Primary practice location

9500 Gilman Dr Dept 304
La Jolla, CA 92093-0304

Mailing address

9500 Gilman Dr Dept 304
La Jolla, CA 92093-0304
Phone (858) 534-3755

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

NPI Registry JSON

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1669730388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR DEPT 304",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930304",
            "telephone_number": "858-534-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DR DEPT 304",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930304",
            "telephone_number": "858-534-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERAZA",
        "first_name": "COURTNEY",
        "middle_name": "CLAY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.