Healthcare Provider Details

I. General information

NPI: 1063931616
Provider Name (Legal Business Name): DANIELLE JO LINDNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4482 BARRANCA PKWY STE 175
IRVINE CA
92604-1746
US

IV. Provider business mailing address

3205 S SYCAMORE ST
SANTA ANA CA
92707-4437
US

V. Phone/Fax

Practice location:
  • Phone: 949-262-7190
  • Fax: 949-262-7193
Mailing address:
  • Phone: 701-446-7369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA8216
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: