Healthcare Provider Details

I. General information

NPI: 1407448921
Provider Name (Legal Business Name): LINDSAY GAIL WOOD LMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 02/05/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 TERRA BELLA
IRVINE CA
92602-1032
US

IV. Provider business mailing address

207 TERRA BELLA
IRVINE CA
92602-1032
US

V. Phone/Fax

Practice location:
  • Phone: 714-206-2820
  • Fax:
Mailing address:
  • Phone: 714-206-2820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number123373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: