Healthcare Provider Details

I. General information

NPI: 1104732866
Provider Name (Legal Business Name): SASHA LINDSEY I
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12390 GOLDEN STATE BLVD
MADERA CA
93637-9156
US

IV. Provider business mailing address

12390 GOLDEN STATE BLVD
MADERA CA
93637-9156
US

V. Phone/Fax

Practice location:
  • Phone: 559-660-4600
  • Fax: 559-223-2989
Mailing address:
  • Phone: 559-660-4600
  • Fax: 559-223-2989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: