Healthcare Provider Details

I. General information

NPI: 1174292528
Provider Name (Legal Business Name): CASSANDRA LLOYD PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TAMAL PLZ STE 200
CORTE MADERA CA
94925-1063
US

IV. Provider business mailing address

100 TAMAL PLZ STE 200
CORTE MADERA CA
94925-1063
US

V. Phone/Fax

Practice location:
  • Phone: 415-945-9870
  • Fax:
Mailing address:
  • Phone: 415-945-9870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number36735
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: