Provider Demographics
NPI:1205042215
Name:NAGAHORI, LYNDA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:M
Last Name:NAGAHORI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 CALLE CERRO
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-6129
Mailing Address - Country:US
Mailing Address - Phone:916-549-1466
Mailing Address - Fax:
Practice Address - Street 1:1131 SAN FELIPE RD
Practice Address - Street 2:
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-2800
Practice Address - Country:US
Practice Address - Phone:831-636-4020
Practice Address - Fax:831-636-4025
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21272103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical