Active NPI
Lissa Michelle Mann-Cervera, MA
- School Psychologist
- Cathedral City, CA
National Provider Identifier
1861258584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 200062042
- Practice address
- 30310 Landau Blvd
Cathedral City, CA 92234-5200 - Phone
- (760) 770-8600
- NPI assigned
- Feb 21, 2024
- Sex
- Female
- Sole proprietor
- No
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 | 200062042 | CA | Primary |
Addresses
Primary practice location
30310 Landau Blvd
Cathedral City, CA 92234-5200
Mailing address
83722 Andes CT
Indio, CA 92203-4035
Phone (857) 719-9421
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200062042 | CA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708473600000",
"number": "1861258584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "83722 ANDES CT",
"city": "INDIO",
"state": "CA",
"postal_code": "922034035",
"telephone_number": "857-719-9421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30310 LANDAU BLVD",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922345200",
"telephone_number": "760-770-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN-CERVERA",
"first_name": "LISSA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-21",
"last_updated": "2024-02-21",
"certification_date": "2024-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "CA",
"license": "200062042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cathedral City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.