Provider Demographics
NPI:1265858971
Name:TOTAH, LYNDA (MSN FNP)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:TOTAH
Suffix:
Gender:F
Credentials:MSN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32565B GOLDEN LANTERN ST # 504
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3248
Mailing Address - Country:US
Mailing Address - Phone:949-466-8014
Mailing Address - Fax:
Practice Address - Street 1:2200 HARBOR BLVD STE B210
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5890
Practice Address - Country:US
Practice Address - Phone:949-548-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95000442363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily