Provider Demographics
NPI:1205143872
Name:LINDSEY, DIANE L (OTA/L)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:L
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24301 CARLTON CT
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3718
Mailing Address - Country:US
Mailing Address - Phone:949-643-9417
Mailing Address - Fax:949-643-9427
Practice Address - Street 1:4655 RUFFNER ST
Practice Address - Street 2:SUITE 270
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2275
Practice Address - Country:US
Practice Address - Phone:858-505-0939
Practice Address - Fax:858-573-0659
Is Sole Proprietor?:No
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOTA 1817224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant