DR. LISA M NAKATA PH.D
NPI 1306913769
Psychologist in Vallejo, CA

Active since November 29, 2006PECOS Enrolled
1761 BROADWAY ST STE 100, VALLEJO, CA 94589(707) 645-2700 Get Directions Write a Review

NPPES record last updated: January 3, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Lisa M Nakata Ph.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LISA M NAKATA PH.D (NPI 1306913769) is an individual psychologist in Vallejo, California, licensed in California (PSY 17809) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306913769
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. LISA M NAKATACredential: PH.D
Location Address1761 BROADWAY ST STE 100Vallejo, CA 94589-2227
Mailing Address1761 Broadway St Ste 100Vallejo, CA 94589-2227 · (707) 645-2700
Sole ProprietorNo
Enumeration DateNovember 29, 2006
Last NPPES UpdateJanuary 3, 2022
✔ NPI 1306913769 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in CA · PSY 17809
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
1761 BROADWAY ST STE 100, Vallejo, CA 94589

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Lisa M Nakata Ph.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Nakata reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Internal Medicine
975 SERENO DRIVE
Vallejo, CA 94589
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
1761 BROADWAY ST STE 100
VALLEJO, CA 94589
Social Worker (Clinical)
1761 BROADWAY ST STE 100
VALLEJO, CA 94589
Marriage & Family Therapist
1761 BROADWAY ST STE 100
VALLEJO, CA 94589
Psychologist
1761 BROADWAY ST STE 100
VALLEJO, CA 94589
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1761 BROADWAY ST STE 100
VALLEJO, CA 94589
Psychologist (Clinical)
1761 BROADWAY ST STE 100
VALLEJO, CA 94589
Psychologist
1761 BROADWAY ST STE 100
VALLEJO, CA 94589
Psychologist (Clinical)
1761 BROADWAY ST STE 100
VALLEJO, CA 94589

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Nakata's NPI number?

The NPI number for Lisa Nakata is 1306913769. It was assigned to this individual provider in the NPPES registry on November 29, 2006.

Where is Lisa Nakata located?

Lisa Nakata practices at 1761 Broadway St Ste 100, Vallejo, CA 94589. The listed phone number is (707) 645-2700.

What is Lisa Nakata's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Lisa Nakata enrolled in Medicare?

Yes. Lisa Nakata is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lisa Nakata's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Nakata reassigns Medicare benefits to Permanente Medical Group Inc (Vallejo, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Nakata's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lisa Nakata was last updated on January 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.