Provider Demographics
NPI:1336311646
Name:LINDER DUNKLE, DUSTA NOELLE (LVN)
Entity Type:Individual
Prefix:
First Name:DUSTA
Middle Name:NOELLE
Last Name:LINDER DUNKLE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 B ST
Mailing Address - Street 2:SUITE 1570
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-4520
Mailing Address - Country:US
Mailing Address - Phone:619-615-0439
Mailing Address - Fax:
Practice Address - Street 1:600 B ST
Practice Address - Street 2:SUITE 1570
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-4520
Practice Address - Country:US
Practice Address - Phone:619-615-0439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA213249164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA213249OtherLVN