Individual provider Active NPI

Alissa E. Scanlin, PSYD

  • Psychologist
  • Lafayette, CA
National Provider Identifier
1891807533
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY20873 Issued in CA
Practice address
3468 Mt Diablo Blvd
B203
Lafayette, CA 94549-3957
Phone
(925) 283-3902
Fax
(707) 371-2433
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY20873 CA Primary

Addresses

Primary practice location

3468 Mt Diablo Blvd
B203
Lafayette, CA 94549-3957

Mailing address

6 Lois LN
Lafayette, CA 94549-3057
Phone (925) 283-3902

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
I20061004000294 CA Practitioner - Clinical Psychologist 8628074226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

344 Village SQ
Orinda, CA 94563-2506
Phone (925) 283-3902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
20873CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Twca Incorporated CurrentSince Jul 1, 2008 Accepting new patients

Locations

3468 Mt Diablo Blvd
Ste B203
Lafayette, CA 94549
Phone (925) 283-3902

344 Village Sq
Orinda, CA 94563
Phone (925) 254-7823

Organizations & group practices 1

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891807533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LOIS LN",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493057",
            "telephone_number": "925-283-3902",
            "fax_number": "707-371-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3468 MT DIABLO BLVD",
            "address_2": "B203",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493957",
            "telephone_number": "925-283-3902",
            "fax_number": "707-371-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLIN",
        "first_name": "ALISSA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY20873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CA

Sources for this page

Verify at the official NPI Registry.