Individual provider Active NPI

Vanessa Lindo, PA-C

  • Physician Assistant
  • Redding, CA
National Provider Identifier
1003377433
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA66269 Issued in CA
Practice address
415 Knollcrest Dr Ste 101
Redding, CA 96002-0181
Phone
(530) 392-4399
Fax
(530) 903-4226
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA66269 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 9383 GA

Addresses

Primary practice location

415 Knollcrest Dr Ste 101
Redding, CA 96002-0181

Mailing address

2171 Ferentz Trce
Norcross, GA 30071-3757
Phone (770) 865-3682

Other names 1

  • Vanessa Lindo Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211130000379 GA Practitioner - Physician Assistant 8224428685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9383GAMDGeneral Practice Dentistry
PA66269CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Medical Center LLC Single Specialty CurrentSince Aug 25, 2021 Accepting new patients
Community Medical Specialists Inc Single Specialty PastSince May 1, 2024 Accepting new patients
Community Medical Specialists Inc Single Specialty PastSince Jan 1, 2023 Accepting new patients

Locations

3455 Peachtree Industrial Blvd
Ste 910
Duluth, GA 30096
Phone (678) 584-5000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1003377433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 FERENTZ TRCE",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300713757",
            "telephone_number": "770-865-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 KNOLLCREST DR STE 101",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020181",
            "telephone_number": "530-392-4399",
            "fax_number": "530-903-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDO",
        "first_name": "VANESSA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66269",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "LINDO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.