Mayra Liliana Quezada, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

31202 Issued in CA

Practice address

530 Lawrence Expy
Sunnyvale, CA 94085-4014

Phone

(408) 475-3757

NPI assigned

Jul 17, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1174965206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 LAWRENCE EXPY",
            "address_2": "PMB 952",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940854014",
            "telephone_number": "408-475-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 LAWRENCE EXPY",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940854014",
            "telephone_number": "408-475-3757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "310-222-3198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5755 Cottle Rd Bldg 4",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951233600",
            "country_code": "US",
            "telephone_number": "408-972-3095 x3343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEZADA",
        "first_name": "MAYRA",
        "middle_name": "LILIANA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "31202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Sunnyvale, CA
• Providers in Sunnyvale, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.