Individual
DR. LYN J. MANGIAMELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
320 S 3RD ST, SUITE 201, SAN JOSE, CA 95112-3648
(415) 999-6793
(408) 736-1272
Mailing address
127 CARSON CT, SUNNYVALE, CA 94086-5822
(415) 999-6793
(408) 736-1272
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY 25076
CA
103TC0700X
Clinical Psychologist
PSY 25076
CA
103TF0200X
Forensic Psychologist
PSY 25076
CA
103TR0400X
Rehabilitation Psychologist
PSY 25076
CA
Other
Enumeration date
04/25/2012
Last updated
07/19/2012
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