Provider Demographics
NPI:1376871186
Name:ELBERT, LINDA L (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:ELBERT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15840 VENTURA BLVD 101
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4737
Mailing Address - Country:US
Mailing Address - Phone:818-789-3811
Mailing Address - Fax:818-906-4169
Practice Address - Street 1:15840 VENTURA BLVD 101
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4737
Practice Address - Country:US
Practice Address - Phone:818-789-3811
Practice Address - Fax:818-906-4169
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA603669163W00000X
CA16687363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse