Individual provider Active NPI

Aikisha Lopez Harley, PH.D.

  • Clinical Neuropsychologist
  • San Mateo, CA
National Provider Identifier
1699252957
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY29883 Issued in CA
Practice address
222 W. 39TH Ave.
Department of Psychiatry
San Mateo, CA 94403-4364
Phone
(650) 573-3668
NPI assigned
Jul 19, 2018
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY10001535 MA
Psychologist 103T00000X PSY29883
Clinical Neuropsychologist 103G00000X PSY29883 CA Primary

Addresses

Primary practice location

222 W. 39TH Ave.
Department of Psychiatry
San Mateo, CA 94403-4364

Mailing address

222 W. 39TH Ave.
Department of Psychiatry
San Mateo, CA 94403-4364
Phone (650) 573-3668

Other practice location 1

833 Market St Ste 809
San Francisco, CA 94103-1828
Phone (415) 627-9095

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
I20190618002586 CA Practitioner - Clinical Psychologist 1456685841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of San MateoGroup PAC ID 9032023171, shared by 15 NPIs, 316 clinicians

Practice addresses (Care Compare)

22 W 39TH Ave
Hos316Ms
San Mateo, CA 94403-4364

222 W 39TH Ave
San Mateo, CA 94403-4364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY29883CAMDClinical Neuropsychologist
PSY10001535MAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Mateo CurrentSince Apr 3, 2021 Accepting new patients
County of San Mateo CurrentSince Apr 3, 2021 Accepting new patients
County of San Mateo CurrentSince Apr 3, 2021 Accepting new patients

Locations

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

Organizations & group practices 3

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": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1699252957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W. 39TH AVE.",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034364",
            "telephone_number": "650-573-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W. 39TH AVE.",
            "address_2": "DEPARTMENT OF PSYCHIATRY",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034364",
            "telephone_number": "650-573-3668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "833 Market St Ste 809",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941031828",
            "country_code": "US",
            "telephone_number": "415-627-9095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "AIKISHA",
        "middle_name": "LOPEZ",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "PSY10001535",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": "PSY29883",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY29883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.