Provider Demographics
NPI:1679934319
Name:LYNDSEY, CLAYTON ERNEST II (LPT)
Entity Type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:ERNEST
Last Name:LYNDSEY
Suffix:II
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1499 W EVANS ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92411-1719
Mailing Address - Country:US
Mailing Address - Phone:909-648-5182
Mailing Address - Fax:
Practice Address - Street 1:275 BAKER ST
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4566
Practice Address - Country:US
Practice Address - Phone:909-648-5182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X, 101YM0800X
CA38300167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No167G00000XNursing Service ProvidersLicensed Psychiatric Technician