Healthcare Provider Details

I. General information

NPI: 1851181069
Provider Name (Legal Business Name): LINZY MARIE SOUSA PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 E SIERRA WAY
DINUBA CA
93618-2448
US

IV. Provider business mailing address

1327 E EL MONTE WAY
DINUBA CA
93618-1825
US

V. Phone/Fax

Practice location:
  • Phone: 559-595-7360
  • Fax:
Mailing address:
  • Phone: 559-595-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number210017365
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: