Healthcare Provider Details

I. General information

NPI: 1053276105
Provider Name (Legal Business Name): LINDSAY CARLSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6461 MILES LN
CARMICHAEL CA
95608-2419
US

IV. Provider business mailing address

6461 MILES LN
CARMICHAEL CA
95608-2419
US

V. Phone/Fax

Practice location:
  • Phone: 530-748-6262
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number95037684
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: