Provider Demographics
NPI:1164824314
Name:VOSBEIN, LYNDA LEE (MA)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:LEE
Last Name:VOSBEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8711 NONYA TERRACE
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92040-5046
Mailing Address - Country:US
Mailing Address - Phone:619-569-8843
Mailing Address - Fax:
Practice Address - Street 1:8711 VIA DIEGO CT
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:CA
Practice Address - Zip Code:92040-5044
Practice Address - Country:US
Practice Address - Phone:619-569-8843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAIMF80150106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health