Provider Demographics
NPI:1245424985
Name:ROPER, LINDSAY JEAN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:JEAN
Last Name:ROPER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:LINDSAY
Other - Middle Name:JEAN
Other - Last Name:JACOBSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:37116 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURNEY
Mailing Address - State:CA
Mailing Address - Zip Code:96013-4127
Mailing Address - Country:US
Mailing Address - Phone:530-335-3206
Mailing Address - Fax:530-335-5383
Practice Address - Street 1:37116 MAIN ST
Practice Address - Street 2:
Practice Address - City:BURNEY
Practice Address - State:CA
Practice Address - Zip Code:96013-4127
Practice Address - Country:US
Practice Address - Phone:530-335-3206
Practice Address - Fax:530-335-5383
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33915225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ50827ZOtherBLUE SHIELD OF CA
CAZZZ05843ZOtherMEDICARE GROUP PTAN
CAZZZ05843ZOtherMEDICARE GROUP PTAN