Active NPI
Lydiana Garcia-Suazo
- Clinical Psychologist
- Burbank, CA
National Provider Identifier
1235387994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY24888
- Practice address
- 3031 N San Fernando Blvd Ste 100
Burbank, CA 91504-4704 - Phone
- (310) 592-5333
- NPI assigned
- Sep 5, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY11720 | FL | |
| Counseling Psychologist | 103TC1900X | 3838 | PR | |
| Counseling Psychologist | 103TC1900X | PSY24888 | CA | |
| Clinical Psychologist | 103TC0700X | PSY24888 | CA | Primary |
Addresses
Primary practice location
3031 N San Fernando Blvd Ste 100
Burbank, CA 91504-4704
Mailing address
30825 Penny Surf Loop
Wesley Chapel, FL 33545-2306
Phone (310) 592-3333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 5, 2017 through Oct 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY24888 | CA | MD | Clinical Psychologist |
| PY11720 | FL | MD | Clinical Psychologist |
| 24888 | CA | MD | Chiropractor |
| 3838 | PR | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686700800000",
"number": "1235387994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30825 PENNY SURF LOOP",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335452306",
"telephone_number": "310-592-3333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3031 N SAN FERNANDO BLVD STE 100",
"city": "BURBANK",
"state": "CA",
"postal_code": "915044704",
"telephone_number": "310-592-5333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA-SUAZO",
"first_name": "LYDIANA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-05",
"last_updated": "2023-06-14",
"certification_date": "2023-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY11720",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "3838",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "PSY24888",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY24888",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.