Active NPI
Lisa Buckley, PHD
- Psychologist
- Encinitas, CA
National Provider Identifier
1699873976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY15155
- Practice address
- 1991 Village Park Way
202B
Encinitas, CA 92024 - Phone
- (760) 943-1226
- Fax
- (760) 634-7961
- NPI assigned
- Sep 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY15155 | CA | Primary |
Addresses
Primary practice location
1991 Village Park Way
202B
Encinitas, CA 92024
Mailing address
1991 Village Park Way
202B
Encinitas, CA 92024
Phone (760) 943-1226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OPL151550 | Other | CA | BCBS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061018000323 | CA | Practitioner - Clinical Psychologist | 5890791636 | Practice locations: Encinitas, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1991 Village Park Way
Suite 202B
Encinitas, CA 92024-1967
Phone (760) 943-1226
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY15155 | CA | MD | Psychologist |
| 15155 | CA | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699873976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1991 VILLAGE PARK WAY",
"address_2": "202B",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "92024",
"telephone_number": "760-943-1226",
"fax_number": "760-634-7961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1991 VILLAGE PARK WAY",
"address_2": "202B",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "92024",
"telephone_number": "760-943-1226",
"fax_number": "760-634-7961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "LISA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY15155",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "OPL151550",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Encinitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.