Individual provider Active NPI

Leigh Dickerson Watson, PH.D.

  • Clinical Psychologist
  • Menlo Park, CA
National Provider Identifier
1851544662
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY21722 Issued in CA
Practice address
1220 University Dr
Suite 103
Menlo Park, CA 94025-4262
Phone
(650) 380-9843
NPI assigned
Oct 24, 2008
Last updated
Oct 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY21722 CA Primary
Clinical Psychologist 103TC0700X 3322 NC

Addresses

Primary practice location

1220 University Dr
Suite 103
Menlo Park, CA 94025-4262

Mailing address

10 Scenic Way
Apt. 216
San Mateo, CA 94403-3161
Phone (650) 380-9843

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
PSY21722CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1851544662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SCENIC WAY",
            "address_2": "APT. 216",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944033161",
            "telephone_number": "650-380-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 UNIVERSITY DR",
            "address_2": "SUITE 103",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254262",
            "telephone_number": "650-380-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LEIGH",
        "middle_name": "DICKERSON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21722",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.