Basic Information
| Provider Information | |||||||||
| NPI: | 1558854000 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RESTELLI | ||||||||
| FirstName: | LYNDSEY | ||||||||
| MiddleName: | |||||||||
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| Credential: | MSN, RN, CPNP-PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8881 FLETCHER PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | LA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919423135 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194646434 | ||||||||
| FaxNumber: | 6194645109 | ||||||||
| Practice Location | |||||||||
| Address1: | 8881 FLETCHER PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | LA MESA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194646434 | ||||||||
| FaxNumber: | 6194645109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2018 | ||||||||
| LastUpdateDate: | 03/12/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0200X | 95112434 | CA | Y | Nursing Service Providers | Registered Nurse | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 20162685 | 01 | PNCB | OTHER |