Individual provider Active NPI

Laraine Marie Lipori, PSY.D.

  • Clinical Psychologist
  • Encinitas, CA
National Provider Identifier
1689019630
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY24972 Issued in CA
Practice address
320 Santa Fe Dr
Suite 100
Encinitas, CA 92024-5138
Phone
(858) 775-6702
Fax
(760) 944-7491
NPI assigned
May 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2013

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 PSY24972 CA Primary

Addresses

Primary practice location

320 Santa Fe Dr
Suite 100
Encinitas, CA 92024-5138

Mailing address

3429 Merrimac Ave
San Diego, CA 92117-1719
Phone (858) 775-6702

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
I20130522000162 CA Practitioner - Clinical Psychologist 7113165796 Practice locations: Encinitas, CA; San Diego, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4405 Manchester Ave
Suite 206
Encinitas, CA 92024-7902
Phone (858) 775-6702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24972CAMDGerontology Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
San Diego Neuropsychology PC Clinical Past Accepting new patients

Organizations & group practices 1

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": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367539200000",
    "number": "1689019630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3429 MERRIMAC AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921171719",
            "telephone_number": "858-775-6702",
            "fax_number": "760-944-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SANTA FE DR",
            "address_2": "SUITE 100",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245138",
            "telephone_number": "858-775-6702",
            "fax_number": "760-944-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPORI",
        "first_name": "LARAINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY24972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.