Provider Demographics
NPI:1134405590
Name:MESSORI, LERYN (PSYD)
Entity type:Individual
Prefix:DR
First Name:LERYN
Middle Name:
Last Name:MESSORI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:LERYN
Other - Middle Name:
Other - Last Name:DOGGETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA; CATC-V
Mailing Address - Street 1:617 VETERANS BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1404
Mailing Address - Country:US
Mailing Address - Phone:415-723-1193
Mailing Address - Fax:
Practice Address - Street 1:617 VETERANS BLVD STE 204
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063
Practice Address - Country:US
Practice Address - Phone:415-723-1193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 103TC1900X
CAPSY31190103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling