Provider Demographics
NPI:1003828211
Name:HOLLAND, LINDA REID (PT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:REID
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:JEANNE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:12678 MONTEREY CYPRESS WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2422
Mailing Address - Country:US
Mailing Address - Phone:858-481-3720
Mailing Address - Fax:
Practice Address - Street 1:3350 LA JOLLA VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92161-0002
Practice Address - Country:US
Practice Address - Phone:858-552-7487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20789225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist