Basic Information
| Provider Information | |||||||||
| NPI: | 1669867875 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | PENDLETON | ||||||||
| NamePrefix: | |||||||||
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| Credential: | BCBA | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1820 W ORANGEWOOD AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928685056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146962862 | ||||||||
| FaxNumber: | 7142429308 | ||||||||
| Practice Location | |||||||||
| Address1: | 1820 W ORANGEWOOD AVE STE 110 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928685056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146962862 | ||||||||
| FaxNumber: | 7142429308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2015 | ||||||||
| LastUpdateDate: | 07/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-15-18568 | CA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.