Provider Demographics
NPI:1619906138
Name:MATHER, LINDA KAY (OT, CHT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:KAY
Last Name:MATHER
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5337 TRUXTUN AVE.
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0641
Mailing Address - Country:US
Mailing Address - Phone:661-324-5520
Mailing Address - Fax:661-633-9970
Practice Address - Street 1:5337 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0641
Practice Address - Country:US
Practice Address - Phone:661-324-5520
Practice Address - Fax:661-324-0122
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT437225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03790ZMedicare ID - Type Unspecified
CAP00941Medicare UPIN