Provider Demographics
NPI:1225673916
Name:ESCOBAR, LINDA CHIN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:CHIN
Last Name:ESCOBAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 EATON DR
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-4743
Mailing Address - Country:US
Mailing Address - Phone:209-481-7075
Mailing Address - Fax:
Practice Address - Street 1:2211 EATON DR
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:CA
Practice Address - Zip Code:95242-4743
Practice Address - Country:US
Practice Address - Phone:209-481-7075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-17
Last Update Date:2019-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT22354225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist