Provider Demographics
NPI:1538492327
Name:MONROE, LINDA (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MONROE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:VAN HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:300 SIERRA COLLEGE DR STE 240
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5086
Mailing Address - Country:US
Mailing Address - Phone:530-273-3400
Mailing Address - Fax:
Practice Address - Street 1:300 SIERRA COLLEGE DR STE 240
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5086
Practice Address - Country:US
Practice Address - Phone:530-273-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
CA20467363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant