Active NPI
David Lund, PSY.D
- Psychologist
- Fresno, CA
National Provider Identifier
1629600267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 4411 E Kings Canyon Rd
Fresno, CA 93702-3604 - Phone
- (559) 453-1008
- NPI assigned
- Feb 11, 2020
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 94025920 | CA | |
| Psychologist | 103T00000X | 94025920 | CA | |
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
4411 E Kings Canyon Rd
Fresno, CA 93702-3604
Mailing address
2074 E Axelson Dr
Fresno, CA 93730-3419
Phone (916) 542-3683
Other practice location 1
3520 E Shields Ave Ste 102
Fresno, CA 93726-6923
Phone (800) 654-3937
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 |
|---|---|---|---|
| 94025920 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1629600267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2074 E AXELSON DR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937303419",
"telephone_number": "916-542-3683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4411 E KINGS CANYON RD",
"city": "FRESNO",
"state": "CA",
"postal_code": "937023604",
"telephone_number": "559-453-1008"
}
],
"practiceLocations": [
{
"address_1": "3520 E Shields Ave Ste 102",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937266923",
"country_code": "US",
"telephone_number": "800-654-3937",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUND",
"first_name": "DAVID",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-11",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "94025920",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "94025920",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.