Provider Demographics
NPI:1538597711
Name:FRAZIER, LINDSEY (PSYD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3874 1/2 RIVIERA DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-6313
Mailing Address - Country:US
Mailing Address - Phone:925-584-4369
Mailing Address - Fax:
Practice Address - Street 1:15644 POMERADO RD STE 305
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2418
Practice Address - Country:US
Practice Address - Phone:858-693-3113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25984103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist