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
State | License ID | Taxonomies |
---|---|---|
103TA0700X, 103TE1100X, 103TH0004X, 103TR0400X, 133N00000X, 222Z00000X, 225100000X, 225400000X, 225700000X, 226300000X | ||
CA | DC17322 | 111N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Not Answered | 103TA0700X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging |
Not Answered | 103TE1100X | Behavioral Health & Social Service Providers | Psychologist | Exercise & Sports |
Not Answered | 103TH0004X | Behavioral Health & Social Service Providers | Psychologist | Health |
Not Answered | 103TR0400X | Behavioral Health & Social Service Providers | Psychologist | Rehabilitation |
Not Answered | 111N00000X | Chiropractic Providers | Chiropractor | |
Not Answered | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | |
Not Answered | 222Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Orthotist | |
Not Answered | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
Not Answered | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | |
Not Answered | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | |
Not Answered | 226300000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Kinesiotherapist |