Provider Demographics
NPI:1992361364
Name:LYNDA TRUESDELL PSYCHOLOGIST, PC
Entity Type:Organization
Organization Name:LYNDA TRUESDELL PSYCHOLOGIST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:TRUESDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-280-5020
Mailing Address - Street 1:25021 ACACIA LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4961
Mailing Address - Country:US
Mailing Address - Phone:949-280-5020
Mailing Address - Fax:855-779-3627
Practice Address - Street 1:15615 ALTON PKWY STE 230
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7306
Practice Address - Country:US
Practice Address - Phone:949-297-6808
Practice Address - Fax:855-779-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-11
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1679982649OtherNPPES