Healthcare Provider Details

I. General information

NPI: 1043621378
Provider Name (Legal Business Name): MEGHANN FLYNN LAI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 WILLOW RD
MENLO PARK CA
94025-2539
US

IV. Provider business mailing address

795 WILLOW RD
MENLO PARK CA
94025-2539
US

V. Phone/Fax

Practice location:
  • Phone: 516-521-2828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number121608
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: