Individual provider Active NPI

Ian J. E. Q. Lowe, PSYD

  • Clinical Psychologist
  • San Diego, CA
National Provider Identifier
1881949048
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY28325 Issued in CA
Practice address
5252 Balboa Ave Ste 500
San Diego, CA 92117-6935
Phone
(619) 949-8994
NPI assigned
Jul 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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 PSY28325 CA Primary

Addresses

Primary practice location

5252 Balboa Ave Ste 500
San Diego, CA 92117-6935

Mailing address

5252 Balboa Ave Ste 500
San Diego, CA 92117-6935
Phone (619) 949-8994

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
I20180206000067 CA Practitioner - Clinical Psychologist 5890055164 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY28325CAMDClinical Psychologist
28325CAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Clinical CurrentSince Dec 31, 2017 Accepting new patients
Regents of the University of California CurrentSince Dec 31, 2017 Accepting new patients

Locations

File 57326
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

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": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1881949048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE STE 500",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176935",
            "telephone_number": "619-949-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5252 BALBOA AVE STE 500",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176935",
            "telephone_number": "619-949-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWE",
        "first_name": "IAN",
        "middle_name": "J. E. Q.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.