Doctor Name: | LINDSEY ANN CLYDE |
NPI Number: | 1215363841 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA23202 |
Business Practice Address: | 2100 Powell St Ste# 900 Emeryville, CA - 946081826 |
Business Phone Number: | 5103502600 |
Business Fax Number: | |
Mailing Address: | 13312 Ranchero Rd, Ste 18-5 OAK HILLS |
State: | CA |
Postal Code: | 923444802 |
Phone Number: | 7602170072 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2013 |
NPI Last Update Date: | 09/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA23202 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |