Provider Demographics
NPI:1922161181
Name:MAYO, LINDA ANN (DC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:MAYO
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 1:1532 SOLANO AVE.
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2120
Mailing Address - Country:US
Mailing Address - Phone:510-524-5800
Mailing Address - Fax:510-524-5806
Practice Address - Street 1:1532 SOLANO AVE.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94707-2120
Practice Address - Country:US
Practice Address - Phone:510-524-5800
Practice Address - Fax:510-524-5806
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16619111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000000016619Medicare ID - Type Unspecified
CAT06207Medicare UPIN