Individual provider Active NPI

Lindsay Fitzpatrick, PSYD

  • Clinical Psychologist
  • Laguna Hills, CA
National Provider Identifier
1689071573
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY26706 Issued in CA
Practice address
23461 S Pointe Dr
Suite 100
Laguna Hills, CA 92653-1547
Phone
(949) 637-8897
NPI assigned
Nov 21, 2014
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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 PSY26706 CA Primary

Addresses

Primary practice location

23461 S Pointe Dr
Suite 100
Laguna Hills, CA 92653-1547

Mailing address

23461 S Pointe Dr
Suite 100
Laguna Hills, CA 92653-1547
Phone (949) 452-0888

Other names 1

  • Lindsay Ann Brackman Former name

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
I20160314001060 CA Practitioner - Clinical Psychologist 1850697178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shanti Orange CountyGroup PAC ID 9537475736, 16 clinicians

Practice addresses (Care Compare)

23461 S Pointe Dr
Suite 100
Laguna Hills, CA 92653-1523
Phone (949) 452-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY26706CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shanti Orange County CurrentSince Mar 1, 2016 Accepting new patients

Locations

23461 S Pointe Dr
Ste 100
Laguna Hills, CA 92653
Phone (949) 452-0888

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1689071573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23461 S POINTE DR",
            "address_2": "SUITE 100",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531547",
            "telephone_number": "949-452-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23461 S POINTE DR",
            "address_2": "SUITE 100",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531547",
            "telephone_number": "949-637-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "LINDSAY",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-21",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "BRACKMAN",
            "middle_name": "ANN",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laguna Hills, CA

Sources for this page

Verify at the official NPI Registry.