Individual
MATTHEW GLEN LEZAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
150 S LOS ROBLES AVE STE 850, PASADENA, CA 91101-4630
(888) 588-8995
Mailing address
305 N CEDAR ST APT 204, GLENDALE, CA 91206-5704
(925) 785-9123
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95010135
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/28/2012
Last updated
01/12/2023
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