MEDICARE: LINDA VI NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	20018	CA

General Provider Information

NPI Number	:	1316251382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA VI NP

Provider Business Mailing Address
First Line	:	10690 SAN PABLO AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-2620
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10690 SAN PABLO AVE
Second Line	:
City	:	EL CERRITO
State	:	CA
Zip	:	94530-2620
Country	:	US
Telephone Number	:	310-365-5261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2010
Last Update Date	:	04/19/2023

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