Individual provider Active NPI

Laura Theresa Beltran, PSY.D.

  • Psychologist
  • Santa Maria, CA
National Provider Identifier
1780801571
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
28281 Issued in CA
Practice address
1125 E Clark Ave Ste A1
Santa Maria, CA 93455-5167
Phone
(805) 448-7469
Fax
(805) 354-0806
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 28281 CA Primary

Addresses

Primary practice location

1125 E Clark Ave Ste A1
Santa Maria, CA 93455-5167

Mailing address

1125 E Clark Ave Ste A1
Santa Maria, CA 93455-5167
Phone (805) 448-7469

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
I20240730003922 CA Practitioner - Clinical Psychologist 9537605126 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

Practice addresses (Care Compare)

1103 E Clark Ave
Suite C
Santa Maria, CA 93455-5145
Phone (805) 448-7469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Counseling and Psychological Services Psychologist CurrentSince Oct 11, 2023 Accepting new patients

Locations

1103 E Clark Ave
Ste C
Santa Maria, CA 93455
Phone (805) 242-6634

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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1780801571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E CLARK AVE STE A1",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555167",
            "telephone_number": "805-448-7469",
            "fax_number": "805-354-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E CLARK AVE STE A1",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934555167",
            "telephone_number": "805-448-7469",
            "fax_number": "805-354-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "LAURA",
        "middle_name": "THERESA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "28281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.