Healthcare Provider Details

I. General information

NPI: 1285953463
Provider Name (Legal Business Name): LINDA SUE JAMESON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2010
Last Update Date: 05/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 BELL LN
QUINCY CA
95971-9123
US

IV. Provider business mailing address

24 S PINION PINE CIR
BLAIRSDEN CA
96103-9712
US

V. Phone/Fax

Practice location:
  • Phone: 530-283-6370
  • Fax:
Mailing address:
  • Phone: 530-836-0737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number449188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: