Provider Demographics
NPI:1225191034
Name:LAPILUSA, JUSTIN A (PSYD)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:A
Last Name:LAPILUSA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9820 SHADOW RD
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-4155
Mailing Address - Country:US
Mailing Address - Phone:619-400-9894
Mailing Address - Fax:
Practice Address - Street 1:3010 1ST AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5816
Practice Address - Country:US
Practice Address - Phone:619-400-9894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25187103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical