Healthcare Provider Details

I. General information

NPI: 1730989666
Provider Name (Legal Business Name): DEJA CHARITA LINTON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 S BROADWAY STE N
SANTA MARIA CA
93454-7886
US

IV. Provider business mailing address

2013 MCBEE HWY
JEFFERSON SC
29718-9453
US

V. Phone/Fax

Practice location:
  • Phone: 805-440-9318
  • Fax: 805-354-7088
Mailing address:
  • Phone: 843-622-4720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12728
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number309563
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP046391T
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP043048T
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: