Lisa Lynn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS 13674 Issued in CA

Practice address

2050 Fairmont Dr
San Leandro, CA 94578-1001

Phone

(530) 613-0446

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625356800000",
    "number": "1821157520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5245 WESTRIDGE AVE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956028801",
            "telephone_number": "530-613-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 FAIRMONT DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781001",
            "telephone_number": "530-613-0446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Kaiser Permanente",
            "address_2": "1660 E Roseville Parkway",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "95661",
            "country_code": "US",
            "telephone_number": "916-973-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "935B Spring St",
            "address_purpose": "LOCATION",
            "city": "Placerville",
            "state": "CA",
            "postal_code": "956674523",
            "country_code": "US",
            "telephone_number": "530-621-6210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LYNN",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2021-07-04",
        "certification_date": "2021-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS13674",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS 13674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Ly
• Lily Wong Ly, PSY.D.
• Jeanie Lynch, MA, MFT
• Molly Aileen Lynch, OTR/L
• Ava Renee Lynn
• Anton Dupree Lyons
• Imari Lyons
• Sakari Dameita Lyons
• Glenda Rae Lytle, RN
• Janice Ma, DDS

• Clinical Social Worker in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2021; 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.