Provider Demographics
NPI:1689743023
Name:WILKINSON-TAYLOR, LINDA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MARIE
Last Name:WILKINSON-TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1876
Mailing Address - Country:US
Mailing Address - Phone:949-597-9786
Mailing Address - Fax:714-964-2277
Practice Address - Street 1:9430 WARNER AVE
Practice Address - Street 2:SUITE K
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-2826
Practice Address - Country:US
Practice Address - Phone:714-963-2200
Practice Address - Fax:714-964-2277
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-16945111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU32287Medicare UPIN