Individual provider Active NPI

Lynn Ellen Gorodsky, PH.D.

  • Clinical Psychologist
  • Menlo Park, CA
National Provider Identifier
1073844668
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY4733 Issued in CA
Practice address
800 Menlo Ave
Suite 212
Menlo Park, CA 94025-4750
Phone
(650) 326-8709
NPI assigned
Jan 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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 PSY4733 CA Primary

Addresses

Primary practice location

800 Menlo Ave
Suite 212
Menlo Park, CA 94025-4750

Mailing address

800 Menlo Ave
Suite 212
Menlo Park, CA 94025-4750
Phone (650) 326-8709

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1073844668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MENLO AVE",
            "address_2": "SUITE 212",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254750",
            "telephone_number": "650-326-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MENLO AVE",
            "address_2": "SUITE 212",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254750",
            "telephone_number": "650-326-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORODSKY",
        "first_name": "LYNN",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY4733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.