Provider Demographics
NPI:1386289825
Name:LINDSAY, STEVEN RICHARD (RD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:RICHARD
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 N PEACH AVE
Mailing Address - Street 2:STE A1
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-7248
Mailing Address - Country:US
Mailing Address - Phone:559-321-7836
Mailing Address - Fax:559-795-5261
Practice Address - Street 1:755 N PEACH AVE
Practice Address - Street 2:STE A1
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-7248
Practice Address - Country:US
Practice Address - Phone:559-392-8090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA340625132700000X
CA86116034133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No132700000XDietary & Nutritional Service ProvidersDietary Manager