Provider Demographics
NPI:1710396825
Name:CANAVESIO, LINDSEY T (ACNP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:T
Last Name:CANAVESIO
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 LINDA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2588
Mailing Address - Country:US
Mailing Address - Phone:707-287-4064
Mailing Address - Fax:707-252-4887
Practice Address - Street 1:4305 LINDA VISTA AVE
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2588
Practice Address - Country:US
Practice Address - Phone:707-287-4064
Practice Address - Fax:707-252-4887
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-04
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001010363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care