Provider Demographics
NPI:1932963634
Name:VAN DER LINDEN, NORMA (COTA)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:VAN DER LINDEN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 LEVANTE ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8226
Mailing Address - Country:US
Mailing Address - Phone:760-889-3431
Mailing Address - Fax:
Practice Address - Street 1:2901 LEVANTE ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-8226
Practice Address - Country:US
Practice Address - Phone:760-889-3431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA474556224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant