Provider Demographics
NPI:1710396825
Name:CANAVESIO, LINDSEY T (ACNP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:T
Last Name:CANAVESIO
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1300 ETHAN WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2296
Mailing Address - Country:US
Mailing Address - Phone:916-679-3590
Mailing Address - Fax:916-482-3647
Practice Address - Street 1:1485 RIVER PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4530
Practice Address - Country:US
Practice Address - Phone:916-679-3590
Practice Address - Fax:916-482-3647
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-04
Last Update Date:2021-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95001010363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care