Individual provider Active NPI

Mark L Lamers, PHD

  • Clinical Psychologist
  • Eureka, CA
National Provider Identifier
1972636595
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 21592 Issued in CA
Practice address
350 E St Ste 206
Eureka, CA 95501-0378
Phone
(707) 296-3558
NPI assigned
Mar 13, 2007
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 21592 CA
Clinical Psychologist 103TC0700X PSY 21592 CA Primary

Addresses

Primary practice location

350 E St Ste 206
Eureka, CA 95501-0378

Mailing address

350 E St Ste 206
Eureka, CA 95501-0378
Phone (707) 296-3558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY 21592CAMDClinical Psychologist
21592CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Humboldt CurrentSince Nov 29, 2016 Accepting new patients
County of Humboldt CurrentSince Nov 29, 2016 Accepting new patients
County of Humboldt Current Accepting new patients

Locations

720 Wood St
Eureka, CA 95501
Phone (707) 268-2900

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1972636595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E ST STE 206",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010378",
            "telephone_number": "707-296-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E ST STE 206",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010378",
            "telephone_number": "707-296-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMERS",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "21592",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 21592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.