Provider Demographics
NPI:1992010987
Name:ZWICKER, LINDSAY TAYLOR
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:TAYLOR
Last Name:ZWICKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BUCHANAN DR
Mailing Address - Street 2:
Mailing Address - City:SAUSALITO
Mailing Address - State:CA
Mailing Address - Zip Code:94965-1650
Mailing Address - Country:US
Mailing Address - Phone:415-331-6161
Mailing Address - Fax:
Practice Address - Street 1:33 BUCHANAN DR
Practice Address - Street 2:
Practice Address - City:SAUSALITO
Practice Address - State:CA
Practice Address - Zip Code:94965-1650
Practice Address - Country:US
Practice Address - Phone:415-331-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64137106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist