Provider Demographics
NPI:1184153124
Name:CUNANAN, LINDSEY ALLISON (NP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ALLISON
Last Name:CUNANAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ALLISON
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12000 OXBOW WAY
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91752-2755
Mailing Address - Country:US
Mailing Address - Phone:909-816-6076
Mailing Address - Fax:
Practice Address - Street 1:2880 HULEN PL
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-2606
Practice Address - Country:US
Practice Address - Phone:951-595-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-04
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily