Active NPI
Jennifer Lynn Lotery, PHD
- Psychologist
- Diamond Springs, CA
National Provider Identifier
1992803183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY11619
- Practice address
- 493 Main St
Suite D
Diamond Springs, CA 95619 - Phone
- (530) 622-6991
- Fax
- (530) 622-6991
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
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 | PSY11619 | CA | Primary |
Addresses
Primary practice location
493 Main St
Suite D
Diamond Springs, CA 95619
Mailing address
493 Main St
Suite D
Diamond Springs, CA 95619
Phone (530) 622-6991
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 |
|---|---|---|---|
| PSY11619 | CA | MD | Psychologist |
| 11619 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992803183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "493 MAIN ST",
"address_2": "SUITE D",
"city": "DIAMOND SPRINGS",
"state": "CA",
"postal_code": "95619",
"telephone_number": "530-622-6991",
"fax_number": "530-622-6991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "493 MAIN ST",
"address_2": "SUITE D",
"city": "DIAMOND SPRINGS",
"state": "CA",
"postal_code": "95619",
"telephone_number": "530-622-6991",
"fax_number": "530-622-6991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOTERY",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY11619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Diamond Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.