Healthcare Provider Details

I. General information

NPI: 1932033636
Provider Name (Legal Business Name): KEZIAH LYU PSYCHOLOGICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

229 POLARIS AVE STE 11
MOUNTAIN VIEW CA
94043-4579
US

IV. Provider business mailing address

229 POLARIS AVE STE 11
MOUNTAIN VIEW CA
94043-4579
US

V. Phone/Fax

Practice location:
  • Phone: 408-539-1229
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KEZIAH LYU
Title or Position: DIRECTOR
Credential: PSYD
Phone: 408-539-1229