Provider Demographics
NPI:1972984896
Name:REYNOLDS, LINDSEY PATRICIA (PA-C, MPH, MSPAS)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:PATRICIA
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:PA-C, MPH, MSPAS
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:PATRICIA
Other - Last Name:DAHLKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1451 SECRET RAVINE PKWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661
Mailing Address - Country:US
Mailing Address - Phone:916-453-8696
Mailing Address - Fax:916-453-8715
Practice Address - Street 1:5609 J STREET
Practice Address - Street 2:SUITE C
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819
Practice Address - Country:US
Practice Address - Phone:916-453-8696
Practice Address - Fax:916-453-8715
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52570363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant