Provider Demographics
NPI:1609082577
Name:MARIA, LINDA SIPPY (PT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SIPPY
Last Name:MARIA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 MOUNT HELIX HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5656
Mailing Address - Country:US
Mailing Address - Phone:619-644-0743
Mailing Address - Fax:
Practice Address - Street 1:9000 WAKARUSA ST
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3307
Practice Address - Country:US
Practice Address - Phone:619-740-4600
Practice Address - Fax:619-589-7638
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15840225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist