Provider Demographics
NPI:1285819441
Name:LINDAUER, KYLE SAN CHUN I (NONE)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:SAN CHUN
Last Name:LINDAUER
Suffix:I
Gender:M
Credentials:NONE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 PRESSLEY ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-5526
Mailing Address - Country:US
Mailing Address - Phone:707-573-6955
Mailing Address - Fax:707-543-8176
Practice Address - Street 1:1410 GUERNEVILLE RD
Practice Address - Street 2:14
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-7231
Practice Address - Country:US
Practice Address - Phone:707-573-6954
Practice Address - Fax:707-577-8347
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health