Provider Demographics
NPI:1942480033
Name:GROSS, LINDA (LAC)
Entity Type:Individual
Prefix:MISS
First Name:LINDA
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:20969 VENTURA BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2305
Mailing Address - Country:US
Mailing Address - Phone:818-943-3647
Mailing Address - Fax:818-344-1570
Practice Address - Street 1:20969 VENTURA BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2305
Practice Address - Country:US
Practice Address - Phone:818-943-3647
Practice Address - Fax:818-344-1570
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC9878171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist