Provider Demographics
NPI:1184054611
Name:GUNN, LINDA PATRICIA (MS/CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:PATRICIA
Last Name:GUNN
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27605 1/2 SCHULTE RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-7927
Mailing Address - Country:US
Mailing Address - Phone:909-961-7547
Mailing Address - Fax:888-588-6274
Practice Address - Street 1:1004 DAVID AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-5443
Practice Address - Country:US
Practice Address - Phone:909-961-7547
Practice Address - Fax:888-588-6274
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12047812235Z00000X
CA19753235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11679214OtherCAQH