John August Lundin, PSY.D.

Individual provider Active NPI Clinical Psychologist · Piedmont, CA

NPI 1164576567 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1164576567
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
PSY19824 (CA)
Practice address
459 Boulevard Way
Piedmont, CA 94610-1526
Phone
(415) 305-0061
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PSY19824CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Gate Psychological Corporation Clinical Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY19824 CA Yes

Addresses

Primary practice location

459 Boulevard Way
Piedmont, CA 94610-1526

Mailing address

934 Carolina St Apt 1
San Francisco, CA 94107-3337
Phone (415) 305-0061

Other providers in Piedmont, CA

All providers in Piedmont, CA · Clinical Psychologist in California

Sources for this page

Verify at the official NPI Registry.