Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ashley Melissa Tate de Lara, PSYD

Individual provider Clinical Psychologist · NPI 1366777906

Ashley Melissa Tate de Lara, PSYD is a Clinical Psychologist in San Jose, California. Qualified in 2008, 18 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
18
Licensed in
CA
In the registry since
2009
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

650 N Winchester Blvd Ste 4
San Jose, CA 95128-1511
Phone: (650) 271-4621
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY23064 (CA)

Record details

NPI number1366777906
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorYes
NPI enumeratedOctober 15, 2009
Last updated in NPPESJanuary 20, 2022
Certification dateJanuary 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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