Provider Demographics
NPI:1689945628
Name:CALLEGARI, LINDA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:CALLEGARI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:333 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2303
Mailing Address - Country:US
Mailing Address - Phone:650-333-1538
Mailing Address - Fax:
Practice Address - Street 1:4370 ALPINE RD STE 104
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7927
Practice Address - Country:US
Practice Address - Phone:650-851-6669
Practice Address - Fax:650-851-9747
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9147363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health