Active NPI
Alexis Roncevich
- Psychologist
- San Diego, CA
National Provider Identifier
1689123150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY61551114
- Practice address
- 9246 Lightwave Ave Ste 120
San Diego, CA 92123-6411 - Phone
- (800) 270-5016
- NPI assigned
- Sep 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY61551114 | WA | Primary |
| Psychologist | 103T00000X | PSY36283 | CA |
Addresses
Primary practice location
9246 Lightwave Ave Ste 120
San Diego, CA 92123-6411
Mailing address
2093 Silverado St
San Marcos, CA 92078-3201
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY36283 | CA | MD | Psychologist |
| PY61551114 | WA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific University | 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.
-
- Adult Mental Health Clinic/Center
- Hillsboro, OR
- NPI 1700256989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775347200000",
"number": "1689123150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2093 SILVERADO ST",
"city": "SAN MARCOS",
"state": "CA",
"postal_code": "920783201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9246 LIGHTWAVE AVE STE 120",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921236411",
"telephone_number": "800-270-5016"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RONCEVICH",
"first_name": "ALEXIS",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-26",
"last_updated": "2026-04-05",
"certification_date": "2026-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY61551114",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY36283",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
- Ronald J. Edelson MD a Medical Corporation
- Ronald McDonald House Charities of San Diego, Inc.
- Ronald R. Harrington, M.D.,a Professional Corporation
- William V. Ronan, M.D.
- Roxane Roncarolo de Vries
- Ronco Chiropractic Incorporated
- Stephen J Ronco, D.C.
- Jose Hipolito Rondon, LVN
- Rong Zou M.D. Inc
- Linda Ronquillo, PSYD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.