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General NPI Number Information
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NPI Number | 1881853067
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Entity Type | Individual
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Provider Name | LYNDA GAYLE REDWINE-ONYSHKO
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Gender | Female
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 4045 BLAIRWOOD DR
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City | MOORPARK
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State | CA
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Zip | 93021-3008
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Country | US
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Telephone | 805-813-0239
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Fax | 805-813-0239
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Provider Business Mailing Address
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Address Line | 438 APPLETON RD
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City | SIMI VALLEY
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State | CA
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Zip | 93065-6008
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Country | US
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Telephone | 805-813-0239
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Fax | 805-813-0239
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 81065
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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