Individual provider Active NPI

Lynn Goren, PHD.

  • Clinical Psychologist
  • Pacific Palisades, CA
National Provider Identifier
1639300080
Registry record updated Aug 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY13693 Issued in CA
Practice address
16494 El Hito PL
Pacific Palisades, CA 90272-2339
Phone
(310) 454-6790
NPI assigned
Aug 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X
Clinical Psychologist 103TC0700X PSY13693 CA Primary

Addresses

Primary practice location

16494 El Hito PL
Pacific Palisades, CA 90272-2339

Mailing address

16494 El Hito PL
Pacific Palisades, CA 90272-2339
Phone (310) 454-6790

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 Philosophy

State licenses

LicenseStateTypeSpecialty
PSY13693CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1639300080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16494 EL HITO PL",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902722339",
            "telephone_number": "310-454-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16494 EL HITO PL",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902722339",
            "telephone_number": "310-454-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOREN",
        "first_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Palisades, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; 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.