Provider Demographics
NPI:1679820930
Name:GOLDSTEIN-FOWLER, LINDSEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:GOLDSTEIN-FOWLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7067
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-7067
Mailing Address - Country:US
Mailing Address - Phone:760-487-1428
Mailing Address - Fax:858-367-8357
Practice Address - Street 1:3790 VIA DE LA VALLE
Practice Address - Street 2:108E
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-4247
Practice Address - Country:US
Practice Address - Phone:760-487-1428
Practice Address - Fax:858-367-8357
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25082103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist