Individual provider Active NPI

Shuyun David Lo, M.D.

  • Psychiatry Physician
  • Santa Cruz, CA
National Provider Identifier
1508807140
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A60210 Issued in CA
Practice address
1156 High St
Santa Cruz, CA 95064-1077
Phone
(831) 459-1329
Fax
(831) 459-5116
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A60210 CA Primary

Addresses

Primary practice location

1156 High St
Santa Cruz, CA 95064-1077

Mailing address

1156 High St
Santa Cruz, CA 95064-1077
Phone (831) 459-1329

Other identifiers 2

IdentifierTypeStateIssuer
A60210OtherCAMEDICAL LICENSE#
00A602100MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A60210CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of California Santa Cruz Current Accepting new patients
University of California Santa Cruz Current Accepting new patients
County of Santa Cruz Past Accepting new patients

Locations

1156 High St
Santa Cruz, CA 95064
Phone (831) 459-2211

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1508807140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 HIGH ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950641077",
            "telephone_number": "831-459-1329",
            "fax_number": "831-459-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 HIGH ST",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950641077",
            "telephone_number": "831-459-1329",
            "fax_number": "831-459-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "SHUYUN",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A60210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE#",
            "identifier": "A60210",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A602100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.