Active NPI
Katiah Llerena, PH.D.
- Clinical Psychologist
- Oakland, CA
National Provider Identifier
1740523026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY28258
- Practice address
- 414 Lake Park Ave
#595
Oakland, CA 94610 - Phone
- (786) 372-0149
- NPI assigned
- Apr 4, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY28258 | CA | Primary |
Addresses
Primary practice location
414 Lake Park Ave
#595
Oakland, CA 94610
Mailing address
414 Lake Park Ave
#595
Oakland, CA 94610-0001
Phone (415) 221-4810
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY28258 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488153600000",
"number": "1740523026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 LAKE PARK AVE",
"address_2": "#595",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946100001",
"telephone_number": "415-221-4810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 LAKE PARK AVE",
"address_2": "#595",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94610",
"telephone_number": "786-372-0149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LLERENA",
"first_name": "KATIAH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-04",
"last_updated": "2017-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY28258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.