Healthcare Provider Details

I. General information

NPI: 1629990668
Provider Name (Legal Business Name): LYNNE NEUBAUER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 41ST AVE STE 201
CAPITOLA CA
95010-3935
US

IV. Provider business mailing address

76 BLACKBIRD CIR
WATSONVILLE CA
95076-7500
US

V. Phone/Fax

Practice location:
  • Phone: 650-862-1379
  • Fax:
Mailing address:
  • Phone: 707-382-8519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number140483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: