Provider Demographics
NPI:1942516786
Name:DEIBLER, LINDSAY (PSYD)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:DEIBLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:HUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:711 E IMPERIAL HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5601
Mailing Address - Country:US
Mailing Address - Phone:714-749-5215
Mailing Address - Fax:
Practice Address - Street 1:711 E IMPERIAL HWY STE 101
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5601
Practice Address - Country:US
Practice Address - Phone:714-749-5215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26147103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical