Provider Demographics
NPI:1598726127
Name:O'FLANAGAN-GORRE, LINNIE ELAINE (LAC)
Entity Type:Individual
Prefix:
First Name:LINNIE
Middle Name:ELAINE
Last Name:O'FLANAGAN-GORRE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:LINNIE
Other - Middle Name:ELAINE
Other - Last Name:O'FLANAGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1700 MEADOW VISTA RD
Mailing Address - Street 2:
Mailing Address - City:MEADOW VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:95722-9534
Mailing Address - Country:US
Mailing Address - Phone:530-878-4828
Mailing Address - Fax:
Practice Address - Street 1:1700 MEADOW VISTA RD
Practice Address - Street 2:
Practice Address - City:MEADOW VISTA
Practice Address - State:CA
Practice Address - Zip Code:95722-9534
Practice Address - Country:US
Practice Address - Phone:530-878-4828
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7618171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist