Healthcare Provider Details

I. General information

NPI: 1003364217
Provider Name (Legal Business Name): MEGHAN LINDQUIST PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 HOSPITAL DR STE 102
UKIAH CA
95482-4568
US

IV. Provider business mailing address

260 HOSPITAL DR STE 102
UKIAH CA
95482-4568
US

V. Phone/Fax

Practice location:
  • Phone: 707-463-7461
  • Fax: 707-463-8018
Mailing address:
  • Phone: 707-463-7461
  • Fax: 707-463-8018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number66943
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: