Provider Demographics
NPI:1568668234
Name:MACKIN, LYNDA ANN (NP)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:ANN
Last Name:MACKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3160 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5219
Mailing Address - Country:US
Mailing Address - Phone:916-733-5701
Mailing Address - Fax:916-733-3401
Practice Address - Street 1:1301 SHOREWAY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-4151
Practice Address - Country:US
Practice Address - Phone:650-596-7000
Practice Address - Fax:650-596-7093
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA7017363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health