Provider Demographics
NPI:1831366418
Name:LINDBLAD, CARL J
Entity type:Individual
Prefix:MR
First Name:CARL
Middle Name:J
Last Name:LINDBLAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 CHILDERS LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-3500
Mailing Address - Country:US
Mailing Address - Phone:408-656-9393
Mailing Address - Fax:830-479-7906
Practice Address - Street 1:124 RIVER ROAD
Practice Address - Street 2:KINSHIP CENTER
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93908
Practice Address - Country:US
Practice Address - Phone:831-455-4725
Practice Address - Fax:831-455-4739
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health