Provider Demographics
NPI:1821284084
Name:BIRKITT, LINDA ANN (REGISTERED PHYSICAL)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:BIRKITT
Suffix:
Gender:F
Credentials:REGISTERED PHYSICAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92693-0541
Mailing Address - Country:US
Mailing Address - Phone:949-246-7784
Mailing Address - Fax:951-678-3484
Practice Address - Street 1:30311 CAMINO CAPISTRANO
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1303
Practice Address - Country:US
Practice Address - Phone:949-246-7784
Practice Address - Fax:951-678-3484
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT7631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT7631AOtherPTAN
CAW15516Medicare UPIN
CAWPT7631AOtherPTAN