Provider Type Icon

LYNNE R. MIELKE M.D. NPI 1700985413


NPI Information

NPI: 1700985413
Provider Name: LYNNE R. MIELKE, M.D.
Classification: Psychiatry & Neurology - 2084P0005X
Entity Type: Individual

Specialization: Neurodevelopmental Disabilities

PECOS Registration: Yes

CLIA Number: 05D2002532

Address:
4463 STONERIDGE DR STE A
PLEASANTON, CA
ZIP 94588
Phone: (925) 846-6300
Get Directions

Lynne R. Mielke, M.D. is a neurodevelopmental disabilities psychiatry neurology in Pleasanton, CA. The provider is a pediatrician or neurologist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system such as cerebral palsy, mental retardation and chronic behavioral syndromes, or neurologic conditions. Lynne R. Mielke, M.D. NPI is 1700985413. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4463 STONERIDGE DR STE A
PLEASANTON, CA
ZIP 94588-402
Phone: (925) 846-6300
Fax: (925) 846-6323

The NPI 1700985413 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D2002532 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/21/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0005XPsychiatry & NeurologyNeurodevelopmental DisabilitiesG59017CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F02058MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.