Provider Demographics
NPI:1235155268
Name:LINDSAY, MICHAEL ALEXANDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALEXANDER
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3655 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-1201
Mailing Address - Country:US
Mailing Address - Phone:619-993-7562
Mailing Address - Fax:
Practice Address - Street 1:4036 3RD AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2102
Practice Address - Country:US
Practice Address - Phone:619-296-8103
Practice Address - Fax:619-296-5027
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13870103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY138700Medicaid
CAPSY138700Medicaid
CAR16792Medicare UPIN