Healthcare Provider Details

I. General information

NPI: 1235051442
Provider Name (Legal Business Name): BAYSHORE PSYCHOLOGICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 POST ST STE 200
SAN FRANCISCO CA
94115-3467
US

IV. Provider business mailing address

2211 POST ST STE 200
SAN FRANCISCO CA
94115-3467
US

V. Phone/Fax

Practice location:
  • Phone: 916-350-0887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. LUKAS NOVAK
Title or Position: PRESIDENT
Credential: PHD
Phone: 916-350-0887