Healthcare Provider Details
I. General information
NPI: 1003880287
Provider Name (Legal Business Name): LINDA MARIE WATTS-SILVA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 02/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 N VENTURA RD SUITE NUMBER 103
OXNARD CA
93030-3841
US
IV. Provider business mailing address
6508 QUAIL STREET
VENTURA CA
93003-2303
US
V. Phone/Fax
- Phone: 805-983-0811
- Fax: 805-983-1481
- Phone: 805-654-8614
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | PT 25466 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: