Healthcare Provider Details

I. General information

NPI: 1578579041
Provider Name (Legal Business Name): LINDA PAULEEN VENEMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA MATNEY MD

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 H ST
BAKERSFIELD CA
93301-1913
US

IV. Provider business mailing address

4301 NORTHSTAR WAY
MODESTO CA
95356-1913
US

V. Phone/Fax

Practice location:
  • Phone: 661-325-0744
  • Fax: 661-859-0230
Mailing address:
  • Phone: 209-577-1200
  • Fax: 209-577-6517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberG33515
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number10252
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number10252
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberG33515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: