Provider Demographics
NPI:1750935359
Name:MOUNTAIN, LYNDSEY ANN (BSC PHYSIOTHERAPY)
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:ANN
Last Name:MOUNTAIN
Suffix:
Gender:F
Credentials:BSC PHYSIOTHERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2255 YGNACIO VALLEY RD STE E
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3349
Mailing Address - Country:US
Mailing Address - Phone:510-930-6680
Mailing Address - Fax:510-930-7867
Practice Address - Street 1:2255 YGNACIO VALLEY RD STE E
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3349
Practice Address - Country:US
Practice Address - Phone:925-930-6680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
CAPT298328225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner