Provider Demographics
NPI:1821217241
Name:LINDQUIST, DAVID S (MFT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:S
Last Name:LINDQUIST
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2836 ALEXANDER
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-4118
Mailing Address - Country:US
Mailing Address - Phone:949-497-7173
Mailing Address - Fax:
Practice Address - Street 1:380 GLENNEYRE ST
Practice Address - Street 2:SUITE D
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2303
Practice Address - Country:US
Practice Address - Phone:949-376-1997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 31978106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist