Individual provider Active NPI

Lauren Richerson

  • Clinical Psychologist
  • Northridge, CA
National Provider Identifier
1811027287
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 24382 Issued in CA
Practice address
9650 Zelzah Ave
Northridge, CA 91325-2003
Phone
(818) 993-9311
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 24382 CA Primary

Addresses

Primary practice location

9650 Zelzah Ave
Northridge, CA 91325-2003

Mailing address

9650 Zelzah Ave
Northridge, CA 91325-2003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20181109002073 MO Practitioner - Clinical Psychologist 5294089207 Practice locations: Kansas City, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

222 W Gregory Blvd
Kansas City, MO 64114-1127
Phone 8163610664208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 24382CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1811027287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9650 ZELZAH AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913252003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 ZELZAH AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913252003",
            "telephone_number": "818-993-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHERSON",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 24382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.