Active NPI
Lisa Lande, PH.D.
- Psychologist
- Espanola, NM
National Provider Identifier
1942531942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1114
- Practice address
- 720 E Hacienda St
Espanola, NM 87532-2523 - Phone
- (505) 753-6769
- NPI assigned
- Jan 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1114 | NM | Primary |
Addresses
Primary practice location
720 E Hacienda St
Espanola, NM 87532-2523
Mailing address
3225 Calle Celestial
Santa Fe, NM 87506-1213
Phone (505) 980-1990
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1114 | NM | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zia Community Cares, LLC | Psychologist | Past | Accepting new patients |
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.
-
- Clinical Psychologist
- Albuquerque, NM
- NPI 1831710490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263513600000",
"number": "1942531942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3225 CALLE CELESTIAL",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875061213",
"telephone_number": "505-980-1990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 E HACIENDA ST",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322523",
"telephone_number": "505-753-6769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDE",
"first_name": "LISA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-15",
"last_updated": "2010-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "1114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.