TYLER LYCKBERG (NPI# 1376024398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376024398 |
Entity Type | Individual |
Full Name | TYLER LYCKBERG |
Practice Address |
1791 Arastradero Rd Palo Alto CA 94304-1337 |
Mailing Address |
232 Brock Rd Nevada City CA 95959-2902 |
Practice Telephone | 8008186136 |
Mailing Telephone | 5305757221 |
Enumeration Date | 2018-08-27 |
Last Update Date | 2018-08-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
1791 ARASTRADERO RD |
City | PALO ALTO |
State | CA |
Zip Code | 94304-1337 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417287301 | Alinne Z Barrera Loucheur | Psychologist | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2009-12-28 |
1922619659 | Carolyn Bradley | Student in an Organized Health Care Education/Training Program | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2020-08-15 |
1972114635 | Jeremy Joves | Student in an Organized Health Care Education/Training Program | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2020-08-14 |
1285244723 | Michael Scott Creekpaum | Student in an Organized Health Care Education/Training Program | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2020-08-07 |
1720698582 | Anusha Murali Kakolu | Student in an Organized Health Care Education/Training Program | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2020-08-06 |
1447860283 | Abigale Jean Brady | Student in an Organized Health Care Education/Training Program | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2020-08-06 |
1609408285 | Casey Mcginnis | Student in an Organized Health Care Education/Training Program | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2020-02-11 |
1164805594 | Katrina Angelina Colby | Counselor | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2015-07-02 |
1134535289 | Loren Pound | Student in an Organized Health Care Education/Training Program | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2014-07-09 |
1194035725 | Shelley Hannah Kay Howell | Clinical Neuropsychologist | 1791 Arastradero Rd, Palo Alto, CA 94304-1337 | 2010-10-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477170611 | Richard Engdahl | Specialist/Technologist, Other | 820 Quarry Road, Mc1078 Hf006, Palo Alo, CA 94304 | 2020-07-04 |
1720603582 | Lily Wenya Zhou | Psychiatry & Neurology | 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 | 2020-06-08 |
1033738521 | Perry Seo Choi | Student in an Organized Health Care Education/Training Program | Dept of Cardiothoracic Surgery, Falk Building, 870 Quarry Rd, Palo Alto, CA 94304 | 2020-04-14 |
1073150355 | Tara Mcdermott | Nurse Practitioner | 500 Pasteur Drive, Cardiovascular Intensive Care Unit, Palo Alto, CA 94304 | 2019-12-05 |
1811542723 | Mark Henry Chubb | Pediatrics | Stanford Children's Health, 725 Welch Road, Palo Alto, CA 94304 | 2019-08-07 |
1194285114 | Cora Steindl | Nurse Practitioner | 300 Pasteur Drive Rm H2512, Stanford, CA 94304 | 2019-03-25 |
1407333057 | Deborah Menet Landi | Social Worker | Lucile Packard Children's Hospital Stanford, 725 Welch, Mc 5933, Palo Alto, CA 94304 | 2018-07-26 |
1982100798 | Jonathan Hootman | Student in an Organized Health Care Education/Training Program | 900 Quarry Road Extension, Palo Alto, CA 94304 | 2018-04-02 |
1093234254 | Adam C Maclellan | Psychiatry & Neurology | Stanford Stroke Center, 780 Welch Road, Suite 350, Palo Alto, CA 94304 | 2017-09-19 |
1194248153 | Chanel Beaudoin Cloutier | Plastic Surgery | 770 Welch Road, Suite 400, Palo Alto, CA 94304 | 2017-07-21 |
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Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033738521 | Perry Seo Choi | Student in an Organized Health Care Education/Training Program | Dept of Cardiothoracic Surgery, Falk Building, 870 Quarry Rd, Palo Alto, CA 94304 | 2020-04-14 |
1952930570 | Jack William Osullivan | Student in an Organized Health Care Education/Training Program | 3801 Miranda Ave Uppr Va, Palo Alto, CA 94304-1207 | 2020-04-06 |
1831727940 | Haley Vertelney | Student in an Organized Health Care Education/Training Program | 2381 Bryant St, Palo Alto, CA 94301-4103 | 2020-04-01 |
1154959773 | Natalia Eugenia Birgisson | Student in an Organized Health Care Education/Training Program | 300 Pasteur Dr Rm H362, Palo Alto, CA 94304-2203 | 2020-03-30 |
1053956896 | Timothy Michael Preston | Student in an Organized Health Care Education/Training Program | 586 Military Way, Palo Alto, CA 94306-3236 | 2019-11-15 |
1154883445 | Daniel Kwangsuk Lee | Student in an Organized Health Care Education/Training Program | Stanford Neuroscience Health Center, 213 Quarry Road, Palo Alto, CA 94304-5979 | 2019-04-04 |
1851853717 | Farrah Liu | Student in an Organized Health Care Education/Training Program | 770 Welch Rd Fl 4, Palo Alto, CA 94304-1511 | 2019-04-01 |
1952892762 | Yair Azoulay | Student in an Organized Health Care Education/Training Program | 3801 Miranda Ave Uppr, Palo Alto, CA 94304-1207 | 2018-05-29 |
1902303969 | Alanna Coughran | Student in an Organized Health Care Education/Training Program | 120 Melville Ave, Palo Alto, CA 94301-3540 | 2018-04-06 |
1144727223 | Kingsley Anuoluwapo Oladeji | Student in an Organized Health Care Education/Training Program | Stanford Health Care Dept. of Gme, 300 Pasteur Drive, Palo Alto, CA 94305 | 2018-04-06 |
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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.