Provider Demographics
NPI:1356021836
Name:LINGSCHEID, SARA (STUDENT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:LINGSCHEID
Suffix:
Gender:
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 ODDSTAD BLVD
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-3854
Mailing Address - Country:US
Mailing Address - Phone:239-223-0056
Mailing Address - Fax:
Practice Address - Street 1:2230 W CHAPMAN AVE # 212
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2316
Practice Address - Country:US
Practice Address - Phone:714-712-0711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA813167163WE0003X
CA95034319363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency