Lauren M. B. Mizock, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY26741 Issued in CA

Practice address

3610 Sacramento St
San Francisco, CA 94118-1734

Phone

(781) 866-1655

NPI assigned

Jun 11, 2008

Last updated

Feb 2, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1427218627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WEDEMEYER ST UNIT 518",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941295281",
            "telephone_number": "781-866-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 SACRAMENTO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181734",
            "telephone_number": "781-866-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZOCK",
        "first_name": "LAUREN",
        "middle_name": "M. B.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY26741",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9557",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Hiroko Miyasaki, D.D.S., PH.D.
• Heather Leigh Miyashiro, NP
• Miyoko Miyata, LAC DNBAO
• Saori Miyazaki Maeshiro, MFT
• Yurio Miyazawa
• Kristine Mizutani
• Anneliese Heather Mizwicki, PA-C
• Daniel Joseph Mizwicki, PA-C
• MKT Dental Care
• MMT Physical Therapy Inc (Apex Physical Therapy SF)

• Clinical Psychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.