Active NPI
Lewis L Canyon, PSY.D.
- Clinical Psychologist
- Castro Valley, CA
National Provider Identifier
1265714125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 34739
- Practice address
- 19310 Parkview Rd
Castro Valley, CA 94546-3733 - Phone
- (510) 798-0068
- NPI assigned
- Sep 15, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 34739 | CA | Primary |
Addresses
Primary practice location
19310 Parkview Rd
Castro Valley, CA 94546-3733
Mailing address
19310 Parkview Rd
Castro Valley, CA 94546-3733
Phone (510) 798-0068
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: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34739 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702598400000",
"number": "1265714125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19310 PARKVIEW RD",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945463733",
"telephone_number": "510-798-0068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19310 PARKVIEW RD",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945463733",
"telephone_number": "510-798-0068"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANYON",
"first_name": "LEWIS",
"middle_name": "L",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-15",
"last_updated": "2023-12-15",
"certification_date": "2023-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "34739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castro Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.