Provider Demographics
NPI:1538456140
Name:MALAVANYA, LYNDA (MD)
Entity type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:
Last Name:MALAVANYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 NOEL DR STE 210
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-3357
Mailing Address - Country:US
Mailing Address - Phone:650-879-9200
Mailing Address - Fax:650-879-9209
Practice Address - Street 1:1040 NOEL DR STE 210
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-3357
Practice Address - Country:US
Practice Address - Phone:650-879-9200
Practice Address - Fax:650-879-9209
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-03
Last Update Date:2011-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG742692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry