Provider Demographics
NPI:1013324557
Name:BEALLO, LINDSEY GAVARNIE-STERN
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:GAVARNIE-STERN
Last Name:BEALLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:STERN
Other - Last Name:BEALLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:592 MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-1821
Mailing Address - Country:US
Mailing Address - Phone:510-292-6772
Mailing Address - Fax:
Practice Address - Street 1:592 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-1821
Practice Address - Country:US
Practice Address - Phone:510-292-6772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula