Healthcare Provider Details

I. General information

NPI: 1336054873
Provider Name (Legal Business Name): LYNDSAY SKEEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 ROBERTSON RD
MODESTO CA
95351-3427
US

IV. Provider business mailing address

3554 MCREYNOLDS AVE
MODESTO CA
95357-0710
US

V. Phone/Fax

Practice location:
  • Phone: 209-574-8402
  • Fax:
Mailing address:
  • Phone: 209-988-6524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number16750
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: