Provider Demographics
NPI:1730313016
Name:FAUCETTE, LINDSEY (DO)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:FAUCETTE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 W BUNNY AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-2805
Mailing Address - Country:US
Mailing Address - Phone:805-739-3561
Mailing Address - Fax:805-739-3560
Practice Address - Street 1:1400 E CHURCH ST
Practice Address - Street 2:BUILDING 8
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:805-739-3561
Practice Address - Fax:805-739-3560
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A13029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB218878OtherMEDICARE ID