Healthcare Provider Details

I. General information

NPI: 1740507458
Provider Name (Legal Business Name): PATRICIA SI-LING LINDAHL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 TELEGRAPH AVE STE 2
BERKELEY CA
94705
US

IV. Provider business mailing address

3120 TELEGRAPH AVE STE 2
BERKELEY CA
94705-1964
US

V. Phone/Fax

Practice location:
  • Phone: 510-761-7649
  • Fax: 510-343-9436
Mailing address:
  • Phone: 510-761-7649
  • Fax: 510-343-9436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA122494
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: