Healthcare Provider Details

I. General information

NPI: 1548322209
Provider Name (Legal Business Name): EMILY WOOD LYNN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 DWIGHT WAY FL 4 BAY PSYCHIATRIC ASSOCIATES
BERKELEY CA
94704-2608
US

IV. Provider business mailing address

2001 DWIGHT WAY FL 4 BAY PSYCHIATRIC ASSOCIATES
BERKELEY CA
94704-2608
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-2461
  • Fax: 510-204-3060
Mailing address:
  • Phone: 510-204-2461
  • Fax: 510-204-3060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA92594
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: