Active NPI
Daniel Suavengco Lumbres, PSYD
- Clinical Psychologist
- Davis, CA
National Provider Identifier
1396389912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY31435
- Practice address
- 207 E St Unit B
Davis, CA 95616-4523 - Phone
- (530) 206-9996
- NPI assigned
- Nov 6, 2019
- Sex
- Male
- Sole proprietor
- No
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 | PSY31435 | CA | Primary |
Addresses
Primary practice location
207 E St Unit B
Davis, CA 95616-4523
Mailing address
1790 Ellis St Apt 11
Concord, CA 94520-2744
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 |
|---|---|---|---|
| PSY31435 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572998400000",
"number": "1396389912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1790 ELLIS ST APT 11",
"city": "CONCORD",
"state": "CA",
"postal_code": "945202744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 E ST UNIT B",
"city": "DAVIS",
"state": "CA",
"postal_code": "956164523",
"telephone_number": "530-206-9996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUMBRES",
"first_name": "DANIEL",
"middle_name": "SUAVENGCO",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-06",
"last_updated": "2019-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY31435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.