Individual provider Active NPI

Maria Anna C Lazo, PSYD

  • Psychologist
  • Sacramento, CA
National Provider Identifier
1881884682
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY25602 Issued in CA
Practice address
1535 River Park Dr Ste 2000
Sacramento, CA 95815-4601
Phone
(916) 286-1010
NPI assigned
Jul 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY25602 CA
Clinical Child & Adolescent Psychologist 103TC2200X PSY25602 CA
Psychologist 103T00000X PSY25602 CA Primary

Addresses

Primary practice location

1535 River Park Dr Ste 2000
Sacramento, CA 95815-4601

Mailing address

1535 River Park Dr Ste 2000
Sacramento, CA 95815-4601
Phone (916) 286-1010

Other names 1

  • Maria Anna Lazo Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240830000804 CA Practitioner - Clinical Psychologist 0143769430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 8022922475, 562 clinicians

Practice addresses (Care Compare)

4860 Y St
Sacramento, CA 95817-2307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY25602CAMDClinical Psychologist
25602CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jun 30, 2024 Accepting new patients
Regents of the University of California CurrentSince Jun 30, 2024 Accepting new patients

Locations

10850 White Rock Rd
Rancho Cordova, CA 95670

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

1535 River Park Dr
Ste 2000
Sacramento, CA 95815
Phone (916) 286-1010

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1881884682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 RIVER PARK DR STE 2000",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154601",
            "telephone_number": "916-286-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 RIVER PARK DR STE 2000",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958154601",
            "telephone_number": "916-286-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZO",
        "first_name": "MARIA ANNA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY25602",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY25602",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY25602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA ANNA",
            "last_name": "LAZO",
            "credential": "PSYD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.