Provider Demographics
NPI:1477660124
Name:LANYI, SHIRLEY J (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:J
Last Name:LANYI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 SPRING ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5263
Mailing Address - Country:US
Mailing Address - Phone:858-495-2533
Mailing Address - Fax:619-589-6840
Practice Address - Street 1:4700 SPRING ST
Practice Address - Street 2:SUITE 204
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5263
Practice Address - Country:US
Practice Address - Phone:858-495-2533
Practice Address - Fax:619-589-6840
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12078A103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP12078Medicare ID - Type Unspecified