Provider Demographics
NPI:1982236006
Name:LINDSTROM, DANIEL W (DPT, PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:W
Last Name:LINDSTROM
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LENNON LN
Mailing Address - Street 2:STE 202
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2433
Mailing Address - Country:US
Mailing Address - Phone:925-934-6373
Mailing Address - Fax:925-934-3363
Practice Address - Street 1:301 LENNON LN STE 202
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2433
Practice Address - Country:US
Practice Address - Phone:925-934-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298129225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty