Ponciano Wellness, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY15130 Issued in CA

Legal business name

PONCIANO WELLNESS, LLC

Practice address

5212 Katella Ave
Suite 202
Los Alamitos, CA 90720-2828

Phone

(888) 568-5640

Fax

(562) 493-0922

NPI assigned

May 12, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Roxana Lambdin, PH.D.

Title

Operating Manager/ Provider

Phone

(888) 568-5640

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Mary Gray, PH.D.

  • Psychologist
  • Los Alamitos, CA
  • NPI 1124066725
  NPD (past)

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1790077543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5212 KATELLA AVE",
            "address_2": "SUITE 202",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202828",
            "telephone_number": "888-568-5640",
            "fax_number": "562-493-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212 KATELLA AVE",
            "address_2": "SUITE 202",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907202828",
            "telephone_number": "888-568-5640",
            "fax_number": "562-493-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCIANO WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "LAMBDIN",
        "authorized_official_first_name": "ROXANA",
        "authorized_official_title_or_position": "OPERATING MANAGER/ PROVIDER",
        "authorized_official_telephone_number": "888-568-5640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1326094442",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John L Pinches III, DO
• Pinnacle Hospice Care, LLC.
• William Poe V, DDS
• Shivanand R Pole, M.D
• Vincent S Polek, MD
• Priscilla Popescu, SLPA, BA
• Sarah Popescu
• Sharon Popp
• Poppy Therapy, a Licensed Clinical Social Worker PC (Poppy Therapy)
• Richard P Poulsen, MPT, ATC

• Clinical Psychologist in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.