Healthcare Provider Details

I. General information

NPI: 1972855203
Provider Name (Legal Business Name): LINDEN OAKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2012
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8699 HOLDER ST
BUENA PARK CA
90620-3614
US

IV. Provider business mailing address

8699 HOLDER ST
BUENA PARK CA
90620-3614
US

V. Phone/Fax

Practice location:
  • Phone: 714-821-3620
  • Fax:
Mailing address:
  • Phone: 714-821-3620
  • Fax: 714-821-5683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number30-66472-6937437
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QA3000X
TaxonomyAugmentative Communication Clinic/Center
License Number30-66472-69377437
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number30-66472-6937437
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number30-66472-6937437
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number30-66472-69377437
License Number StateCA

VIII. Authorized Official

Name: DARREN SHAW
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 714-821-3620