Provider Demographics
NPI:1306485941
Name:LINDQUIST, LISA CHRISTINE (LVN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CHRISTINE
Last Name:LINDQUIST
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7366 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-3741
Mailing Address - Country:US
Mailing Address - Phone:951-858-5732
Mailing Address - Fax:
Practice Address - Street 1:23463 LAWLESS RD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-3527
Practice Address - Country:US
Practice Address - Phone:951-214-2213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-30
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider