Healthcare Provider Details

I. General information

NPI: 1932853819
Provider Name (Legal Business Name): LINDA LOBBESTAEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7949 NORMAL AVE
LA MESA CA
91941-6307
US

IV. Provider business mailing address

7949 NORMAL AVE
LA MESA CA
91941-6307
US

V. Phone/Fax

Practice location:
  • Phone: 858-699-3987
  • Fax:
Mailing address:
  • Phone: 858-699-3987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP5016410
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberNP5016410
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberNP5016410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: