Healthcare Provider Details

I. General information

NPI: 1790478154
Provider Name (Legal Business Name): LINDA MARGARITA REIDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W PUEBLO ST
SANTA BARBARA CA
93105-4230
US

IV. Provider business mailing address

1205 CARDIGAN AVE
VENTURA CA
93004-2556
US

V. Phone/Fax

Practice location:
  • Phone: 805-879-0670
  • Fax: 805-898-3611
Mailing address:
  • Phone: 805-766-0549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number739170
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9507288
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: