Provider Demographics
NPI:1164962668
Name:GENDREAU, LINDSEY MARIE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:MARIE
Last Name:GENDREAU
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:SHINGLETOWN
Mailing Address - State:CA
Mailing Address - Zip Code:96088-0460
Mailing Address - Country:US
Mailing Address - Phone:415-685-6195
Mailing Address - Fax:
Practice Address - Street 1:2534 JUDAH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1438
Practice Address - Country:US
Practice Address - Phone:415-449-2916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42879225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist