Active NPI
Roger James Lyons, PSY.D.
- Clinical Psychologist
- Hanford, CA
National Provider Identifier
1245508084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23939
- Practice address
- 860 E Grangeville Blvd SPC 71
Hanford, CA 93230-2292 - Phone
- (719) 429-1404
- NPI assigned
- Dec 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 23939 | CA | Primary |
| Forensic Psychologist | 103TF0200X | 23939 | CA |
Addresses
Primary practice location
860 E Grangeville Blvd SPC 71
Hanford, CA 93230-2292
Mailing address
860 E Grangeville Blvd SPC 71
Hanford, CA 93230-2292
Phone (719) 429-1404
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23939 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1245508084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 E GRANGEVILLE BLVD SPC 71",
"city": "HANFORD",
"state": "CA",
"postal_code": "932302292",
"telephone_number": "719-429-1404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 E GRANGEVILLE BLVD SPC 71",
"city": "HANFORD",
"state": "CA",
"postal_code": "932302292",
"telephone_number": "719-429-1404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYONS",
"first_name": "ROGER",
"middle_name": "JAMES",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-08",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "23939",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "23939",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.