Provider Demographics
NPI:1881740702
Name:PLANCHON, LYNN A (PHD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:A
Last Name:PLANCHON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39560 STEVENSON PL
Mailing Address - Street 2:SUITE 215
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3074
Mailing Address - Country:US
Mailing Address - Phone:510-209-9018
Mailing Address - Fax:510-793-7554
Practice Address - Street 1:39560 STEVENSON PL
Practice Address - Street 2:SUITE 215
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3074
Practice Address - Country:US
Practice Address - Phone:510-209-9018
Practice Address - Fax:510-793-7554
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY19084103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical