Provider Demographics
NPI:1720122872
Name:LEVY, LINDA (RN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3562 MERCER LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-2330
Mailing Address - Country:US
Mailing Address - Phone:619-543-3518
Mailing Address - Fax:619-543-7584
Practice Address - Street 1:3562 MERCER LN
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-2330
Practice Address - Country:US
Practice Address - Phone:619-543-3518
Practice Address - Fax:619-543-7584
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252792174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist