Provider Demographics
NPI:1700082294
Name:ELYAD, LINDA S (DC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:ELYAD
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 1:325 SAN DIMAS AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-7202
Mailing Address - Country:US
Mailing Address - Phone:760-994-6058
Mailing Address - Fax:
Practice Address - Street 1:325 SAN DIMAS AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-7202
Practice Address - Country:US
Practice Address - Phone:760-439-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TA0700X, 103TE1100X, 103TH0004X, 103TR0400X, 133N00000X, 222Z00000X, 225100000X, 225400000X, 225700000X, 226300000X
CADC17322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Not Answered103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Not Answered226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist