Provider Demographics
NPI:1457739435
Name:FIELDS, LINDA COLER (DAOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:COLER
Last Name:FIELDS
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 20TH ST
Mailing Address - Street 2:APARTMENT 2
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5638
Mailing Address - Country:US
Mailing Address - Phone:310-488-2790
Mailing Address - Fax:
Practice Address - Street 1:12655 W WASHINGTON BLVD STE 106
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-2399
Practice Address - Country:US
Practice Address - Phone:310-943-9044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16508171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist