Provider Demographics
NPI:1295181352
Name:CARTER, LYNDA (LAC)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 RINCON AVE
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-4029
Mailing Address - Country:US
Mailing Address - Phone:760-703-4059
Mailing Address - Fax:
Practice Address - Street 1:8950 VILLA LA JOLLA DR
Practice Address - Street 2:SUITE B-129
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1714
Practice Address - Country:US
Practice Address - Phone:858-450-0620
Practice Address - Fax:858-450-2175
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17079171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist