Provider Demographics
NPI:1750420923
Name:HEWITT, LINDY (LINDY HEWITT MFT)
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:
Last Name:HEWITT
Suffix:
Gender:F
Credentials:LINDY HEWITT MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 3RD AVE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-4051
Mailing Address - Country:US
Mailing Address - Phone:650-558-0592
Mailing Address - Fax:650-685-8179
Practice Address - Street 1:205 E 3RD AVE
Practice Address - Street 2:SUITE 315
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4051
Practice Address - Country:US
Practice Address - Phone:650-558-0592
Practice Address - Fax:650-685-8179
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39521101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA80541OtherPROVIDER NUMBER MEDI-CAL