Provider Demographics
NPI:1144720046
Name:PALMER, LINDSAY LEE (PSYD)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:LEE
Last Name:PALMER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:LEE
Other - Last Name:ALHADEFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:18677 CHAMPIONSHIP DR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-7062
Mailing Address - Country:US
Mailing Address - Phone:714-287-3810
Mailing Address - Fax:
Practice Address - Street 1:4199 CAMPUS DR STE 550
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-4694
Practice Address - Country:US
Practice Address - Phone:714-287-3810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29304103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical