Susan Lynette Lyon, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11463 Issued in CA

Practice address

10440 Black Mountain Rd
San Diego Miramar College Student Health Services S-103
San Diego, CA 92126

Phone

(858) 536-7881

Fax

(858) 689-0387

NPI assigned

Oct 15, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lynette Lyon Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1043462690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10440 BLACK MOUNTAIN RD.",
            "address_2": "SAN DIEGO MIRAMAR COLLEGE, STUDENT HEALTH SERVICES S103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92126",
            "telephone_number": "858-536-7881",
            "fax_number": "858-689-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10440 BLACK MOUNTAIN RD",
            "address_2": "SAN DIEGO MIRAMAR COLLEGE STUDENT HEALTH SERVICES S-103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92126",
            "telephone_number": "858-536-7881",
            "fax_number": "858-689-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYON",
        "first_name": "SUSAN",
        "middle_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "11463",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "403159",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNETTE",
            "last_name": "LYON",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Howard S Lyon, MD
• James W Lyon, MD
• Jonathan Lyon
• Ronit Yael Lyon, MD
• Stephen Lyon, P.A.
• William E Lyon, PA
• Denali Lyons-Bygum
• Anna Lynn Lyons, LMFT
• James P. Lyons, MD
• Jennifer Lee Lyons, PA-C

• Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.