Healthcare Provider Details

I. General information

NPI: 1326525189
Provider Name (Legal Business Name): LINZIE WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2018
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1828 OCEANSIDE BLVD
OCEANSIDE CA
92054-3452
US

IV. Provider business mailing address

1739 WOODBINE PL
OCEANSIDE CA
92054-5649
US

V. Phone/Fax

Practice location:
  • Phone: 844-316-7979
  • Fax: 866-813-1235
Mailing address:
  • Phone: 949-689-1762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number294990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: