Healthcare Provider Details

I. General information

NPI: 1649307950
Provider Name (Legal Business Name): LINDSEY AMBER WEHN M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

776 S STATE ST
UKIAH CA
95482-5847
US

IV. Provider business mailing address

309 ELBRIDGE AVE
CLOVERDALE CA
95425-4469
US

V. Phone/Fax

Practice location:
  • Phone: 707-463-4915
  • Fax:
Mailing address:
  • Phone: 707-287-1240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number51782
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT51782
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: