Healthcare Provider Details

I. General information

NPI: 1528922523
Provider Name (Legal Business Name): LINDA KROUCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SUPERIOR AVE STE 230
NEWPORT BEACH CA
92663-2779
US

IV. Provider business mailing address

320 SUPERIOR AVE STE 230
NEWPORT BEACH CA
92663-2779
US

V. Phone/Fax

Practice location:
  • Phone: 949-645-7870
  • Fax:
Mailing address:
  • Phone: 949-645-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95037476
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: