Provider Demographics
NPI:1558525105
Name:HERRERA, LINDA R (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:HERRERA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-2517
Mailing Address - Country:US
Mailing Address - Phone:530-666-2868
Mailing Address - Fax:
Practice Address - Street 1:34 DAWN DR
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-2517
Practice Address - Country:US
Practice Address - Phone:530-666-2868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist