Healthcare Provider Details

I. General information

NPI: 1952037780
Provider Name (Legal Business Name): LINDSEY ANNE SLANEY YOUNG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY ANNE SLANEY

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18301 VON KARMAN AVE STE 310
IRVINE CA
92612-0115
US

IV. Provider business mailing address

9928 CONTINENTAL DR
HUNTINGTON BEACH CA
92646-4229
US

V. Phone/Fax

Practice location:
  • Phone: 949-645-3534
  • Fax:
Mailing address:
  • Phone: 714-293-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA64965
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: