Individual provider Active NPI

Elizabeth Lavenson Myers, PH.D,

  • Clinical Psychologist
  • Concord, CA
National Provider Identifier
1053664524
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY9862 Issued in CA
Practice address
1157 Fair Weather Cir
Concord, CA 94518-1939
Phone
(925) 459-0173
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY9862 CA Primary

Addresses

Primary practice location

1157 Fair Weather Cir
Concord, CA 94518-1939

Mailing address

1157 Fair Weather Cir
Concord, CA 94518-1939
Phone (925) 459-0173

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY9862CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1053664524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 FAIR WEATHER CIR",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945181939",
            "telephone_number": "925-459-0173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157 FAIR WEATHER CIR",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945181939",
            "telephone_number": "925-459-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "ELIZABETH",
        "middle_name": "LAVENSON",
        "credential": "PH.D,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY9862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.