Provider Demographics
NPI:1194942318
Name:FERREIRA, LYNSEY RENE
Entity type:Individual
Prefix:MS
First Name:LYNSEY
Middle Name:RENE
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-4739
Mailing Address - Country:US
Mailing Address - Phone:209-826-5360
Mailing Address - Fax:
Practice Address - Street 1:320 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-1808
Practice Address - Country:US
Practice Address - Phone:831-643-9069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA44CFOtherMEDI-CAL PRV NBR
CA27BW8OtherMEDI-CAL PRV NBR
CAB8093692OtherDRIVER'S LICENSE