Provider Demographics
NPI:1306855010
Name:BOJORQUEZ, LINDA MARIE (RN,MSN,ACNP-BC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:BOJORQUEZ
Suffix:
Gender:F
Credentials:RN,MSN,ACNP-BC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:LANGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, MSN, ACNP-BC
Mailing Address - Street 1:3540 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4844
Mailing Address - Country:US
Mailing Address - Phone:562-726-1980
Mailing Address - Fax:
Practice Address - Street 1:25825 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3518
Practice Address - Country:US
Practice Address - Phone:310-517-2125
Practice Address - Fax:310-517-4292
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA526089363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ33954Medicare UPIN
CAWNP10127EMedicare ID - Type Unspecified
CAWNP10127FMedicare ID - Type Unspecified
CAWNP10127DMedicare ID - Type Unspecified
CAWNP10127BMedicare ID - Type Unspecified
CAWNP10127CMedicare ID - Type Unspecified