Healthcare Provider Details

I. General information

NPI: 1598309965
Provider Name (Legal Business Name): LINDSAY ELIZONDO PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY ALLEN

II. Dates (important events)

Enumeration Date: 10/29/2019
Last Update Date: 10/25/2021
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 LAUREL ST
SAN DIEGO CA
92101-1630
US

IV. Provider business mailing address

317 LAUREL ST
SAN DIEGO CA
92101-1630
US

V. Phone/Fax

Practice location:
  • Phone: 619-289-7597
  • Fax: 619-354-7283
Mailing address:
  • Phone: 619-289-7597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY31249
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: