Lynlee Ann Lyckberg, REG PSYCH ASSOCIATE

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSB94028907 Issued in CA

Practice address

399 Taylor Blvd Ste 210
Pleasant Hill, CA 94523-2287

Phone

(530) 575-5362

NPI assigned

Dec 30, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1790220671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 BROCK RD",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959592902",
            "telephone_number": "530-575-5362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 TAYLOR BLVD STE 210",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945232287",
            "telephone_number": "530-575-5362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYCKBERG",
        "first_name": "LYNLEE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "REG PSYCH ASSOCIATE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-30",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94028907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Pleasant Hill, CA
• Providers in Pleasant Hill, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2025; 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.