Provider Demographics
NPI:1205359254
Name:THORNTON, LYNDSI W (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:LYNDSI
Middle Name:W
Last Name:THORNTON
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:LYNDSI
Other - Middle Name:M
Other - Last Name:WORTHINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1403 OLD RANCH RD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-4412
Mailing Address - Country:US
Mailing Address - Phone:913-526-8301
Mailing Address - Fax:
Practice Address - Street 1:19634 VENTURA BLVD STE 303
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6022
Practice Address - Country:US
Practice Address - Phone:913-526-8301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100377106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist