Provider Demographics
NPI:1568752095
Name:MENEKEN, LINDA HIDZICK
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:HIDZICK
Last Name:MENEKEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:HIDZICK
Other - Last Name:MENEKEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1220 TRAUD DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 MUIR RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4668
Practice Address - Country:US
Practice Address - Phone:925-372-2214
Practice Address - Fax:925-372-4662
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist