Healthcare Provider Details

I. General information

NPI: 1659065720
Provider Name (Legal Business Name): LINDSAY GROVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4038 S MOONEY BLVD
VISALIA CA
93277-9306
US

IV. Provider business mailing address

3875 W BEECHWOOD AVE
FRESNO CA
93711-0795
US

V. Phone/Fax

Practice location:
  • Phone: 559-646-6618
  • Fax: 559-646-3652
Mailing address:
  • Phone: 559-646-6618
  • Fax: 559-646-3652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA66942
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: