Provider Demographics
NPI:1932496460
Name:NOBLE-LINDSAY, BETHANY LYNN (MA)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LYNN
Last Name:NOBLE-LINDSAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:
Other - Last Name:NOBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4625 MUNROE ST
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-8824
Mailing Address - Country:US
Mailing Address - Phone:619-403-9143
Mailing Address - Fax:
Practice Address - Street 1:2831 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3802
Practice Address - Country:US
Practice Address - Phone:619-403-9143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85089106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist