Active NPI
Rebecca J Lundeen, ED.D.
- School Psychologist
- Norco, CA
National Provider Identifier
1790461226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 220115915
- Practice address
- 4102 California Ave
Norco, CA 92860-1783 - Phone
- (714) 475-9286
- NPI assigned
- Jun 27, 2023
- Last updated
- Jun 28, 2023
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 220115915 | CA | Primary |
Addresses
Primary practice location
4102 California Ave
Norco, CA 92860-1783
Mailing address
4102 California Ave
Norco, CA 92860-1783
Phone (714) 475-9286
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220115915 | CA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1790461226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 CALIFORNIA AVE",
"city": "NORCO",
"state": "CA",
"postal_code": "928601783",
"telephone_number": "714-475-9286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 CALIFORNIA AVE",
"city": "NORCO",
"state": "CA",
"postal_code": "928601783",
"telephone_number": "714-475-9286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDEEN",
"first_name": "REBECCA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-27",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "220115915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.