Individual provider Active NPI

Lisa Burgert Campbell, PH.D.

  • Psychologist
  • San Diego, CA
National Provider Identifier
1841459161
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY21962 Issued in CA
Practice address
8810 Rio San Diego Dr
San Diego, CA 92108-1698
Phone
(619) 400-5120
Fax
(619) 400-5171
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY21962 CA Primary

Addresses

Primary practice location

8810 Rio San Diego Dr
San Diego, CA 92108-1698

Mailing address

8810 Rio San Diego Dr
San Diego, CA 92108-1698
Phone (619) 400-5120

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

LicenseStateTypeSpecialty
PSY21962CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1841459161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8810 RIO SAN DIEGO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081698",
            "telephone_number": "619-400-5120",
            "fax_number": "619-400-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8810 RIO SAN DIEGO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081698",
            "telephone_number": "619-400-5120",
            "fax_number": "619-400-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "LISA",
        "middle_name": "BURGERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY21962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.