Basic Information
| Provider Information | |||||||||
| NPI: | 1760954002 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSE | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | PAIGE | ||||||||
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| Credential: | MSW, ASW | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1855 W KATELLA AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928673432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143993480 | ||||||||
| FaxNumber: | 7143993481 | ||||||||
| Practice Location | |||||||||
| Address1: | 1855 W KATELLA AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928673432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143993480 | ||||||||
| FaxNumber: | 7143993481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2018 | ||||||||
| LastUpdateDate: | 09/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | ASW109837 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.