Provider Demographics
NPI:1780223842
Name:DONELLAN, LINDSAY KRISTINE
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:KRISTINE
Last Name:DONELLAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WATERFORD TER
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2849
Mailing Address - Country:US
Mailing Address - Phone:650-759-0182
Mailing Address - Fax:
Practice Address - Street 1:102 WATERFORD TER
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2849
Practice Address - Country:US
Practice Address - Phone:650-759-0182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23991235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist