Lyn J. Mangiameli, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY 25076 Issued in CA

Practice address

320 S 3Rd St
Suite 201
San Jose, CA 95112-3648

Phone

(415) 999-6793

Fax

(408) 736-1272

NPI assigned

Apr 25, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1134487333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CARSON CT",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940865822",
            "telephone_number": "415-999-6793",
            "fax_number": "408-736-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S 3RD ST",
            "address_2": "SUITE 201",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951123648",
            "telephone_number": "415-999-6793",
            "fax_number": "408-736-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIAMELI",
        "first_name": "LYN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 25076",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY 25076",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "PSY 25076",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "CA",
            "license": "PSY 25076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Chamberlain Manela, PSY.D.
• Stefania Manetti, R.D., CDE
• Laurel Joy Manfredi
• Hardev Singh Mangat, D.D.S.
• Rekha P Manghnani, MD
• Supriya Ameesh Maniar-Oza, P.T.
• Cecilia L. Manibo, M.D.
• Kathleen Velarde Maniquis
• Liam Jonel Isaiah Rivera Maniquis
• Manjari Aravamuthan MD PC

• Clinical Neuropsychologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.