Provider Demographics
NPI:1992834386
Name:PEARCE, LINDA L (PNP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:PEARCE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12752 CRESTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-5250
Mailing Address - Country:US
Mailing Address - Phone:714-636-2726
Mailing Address - Fax:
Practice Address - Street 1:9802 WOODBURY AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2819
Practice Address - Country:US
Practice Address - Phone:714-663-6411
Practice Address - Fax:714-663-6470
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASS3066522261QS1000X
CA741363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA203576OtherREGISTERED NURSE LICENSE