MATTHEW GLEN LEZAMA (NPI# 1093063745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093063745 |
| Entity Type | Individual |
| Full Name | MATTHEW GLEN LEZAMA |
| Credential | PMHNP-BC |
| Practice Address |
66 Hurlbut St Pasadena CA 91105-4025 |
| Mailing Address |
925 S Holt Ave Apt 5 Los Angeles CA 90035-2024 |
| Practice Telephone | 6264414221 |
| Mailing Telephone | 9257859123 |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2019-02-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
95010135 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 Portrero Ave, San Francisco, CA 941103518 | 4152068000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793858 | Matthew Alexander Lezama | Case Manager/Care Coordinator | 520 Dudley St, Roxbury, MA 02119-2769 | 2019-10-29 |
| Street Address |
66 HURLBUT ST |
| City | PASADENA |
| State | CA |
| Zip Code | 91105-4025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134225519 | Pacific Clinics | Community/Behavioral Health | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2006-09-15 |
| 1972102044 | Katrina Willow Yanez | Case Manager/Care Coordinator | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2020-10-20 |
| 1942817846 | Talia Sara Ram | Student in an Organized Health Care Education/Training Program | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2020-09-25 |
| 1043826217 | Veronica Diane Silva | Student in an Organized Health Care Education/Training Program | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2020-09-22 |
| 1306454277 | Courtney Derek White | Student in an Organized Health Care Education/Training Program | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2020-07-16 |
| 1649896408 | Melissa Ann Dover | Student in an Organized Health Care Education/Training Program | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2020-06-17 |
| 1003454414 | Amanda Jane De Wolf | Counselor | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2019-12-16 |
| 1588202998 | Sara Elizabeth Pineda Reyes | Case Manager/Care Coordinator | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2019-12-16 |
| 1659929073 | Jeffrey Najarro | Case Manager/Care Coordinator | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2019-08-28 |
| 1669024097 | Yasmin Guadalupe Montoya | Case Manager/Care Coordinator | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2019-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235267006 | Mumbi L Ngunjiri | Nurse Practitioner | 1845 N Fair Oaks Ave, Suite 2600, Pasadena, CA 91103-1620 | 2007-03-01 |
| 1376632471 | Jane Elizabeth Mathews | Nurse Practitioner | 200 E Del Mar Blvd Ste 122, Pasadena, CA 91105-2551 | 2006-10-12 |
| 1528680873 | Amy Foehrkolb, Lcpc LLC | Nurse Practitioner | 8021 Ritchie Hwy, Pasadena, MD 21122-1047 | 2020-05-09 |
| 1467961565 | George Lam | Nurse Practitioner | 66 Hurlbut St, Pasadena, CA 91105-4025 | 2017-09-21 |
| 1275050437 | Gregory Christopher Stavaridis | Nurse Practitioner | 2900 E Del Mar Blvd, Pasadena, CA 91107-4375 | 2017-08-28 |
| 1669546644 | Arlene P Emery I | Nurse Practitioner | 4002 Burke Rd Ste 100, Pasadena, TX 77504-3451 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154573 | Marcus Jang | Nurse Practitioner | 1130 E Colorado St Apt 214, Glendale, CA 91205-2092 | 2020-11-04 |
| 1033718580 | John Sylvanus Allieu Sr. | Nurse Practitioner | 2672 Merganser Ct, Los Banos, CA 93635-9473 | 2020-10-25 |
| 1316546930 | Chika U Oguagha | Nurse Practitioner | 16240 Carmine St, Fontana, CA 92336-1481 | 2020-10-23 |
| 1215534888 | Rosa Maria Aguero | Nurse Practitioner | 9841 Alburtis Ave Unit 29, Santa Fe Springs, CA 90670-3264 | 2020-10-06 |
| 1134726995 | Margarita Maghtesyan | Nurse Practitioner | 20251 Ventura Blvd Ste A, Woodland Hills, CA 91364-2564 | 2020-10-05 |
| 1043827140 | April Lopez Ortiz | Nurse Practitioner | 500 W Ashland Ct, Visalia, CA 93277-6609 | 2020-09-23 |
| 1477167666 | David Joseph Russell | Nurse Practitioner | 17846 Glenwood Rd, Manteca, CA 95336-9521 | 2020-09-03 |
| 1194339382 | Albert Liu | Nurse Practitioner | 43559 Southerland Way, Fremont, CA 94539-5931 | 2020-09-03 |
| 1407469554 | Andre Alexandrian | Nurse Practitioner | 1606 Winona Ave, Burbank, CA 91504-2823 | 2020-08-28 |
| 1790398238 | Heather Richardson | Nurse Practitioner | 112 S Park St Ste 1, San Francisco, CA 94107-1809 | 2020-08-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MATTHEW GLEN LEZAMA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.