Healthcare Provider Details

I. General information

NPI: 1063088623
Provider Name (Legal Business Name): LINDSAY MOSAKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 CULVER BLVD # V188
PLAYA DEL REY CA
90293-7704
US

IV. Provider business mailing address

322 CULVER BLVD # V188
PLAYA DEL REY CA
90293-7704
US

V. Phone/Fax

Practice location:
  • Phone: 424-216-8015
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW025607
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number135223
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: