Healthcare Provider Details

I. General information

NPI: 1619898095
Provider Name (Legal Business Name): LYNDSEY MALVESTUTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10785 RAMSGATE DR
SANTEE CA
92071-2821
US

IV. Provider business mailing address

10785 RAMSGATE DR
SANTEE CA
92071-2821
US

V. Phone/Fax

Practice location:
  • Phone: 619-971-1711
  • Fax:
Mailing address:
  • Phone: 619-971-1711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number95082845
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: