Healthcare Provider Details

I. General information

NPI: 1831016591
Provider Name (Legal Business Name): LINDA UDOFFIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA FAYE FERGUSON

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27555 YNEZ RD STE 300
TEMECULA CA
92591-4678
US

IV. Provider business mailing address

412 BLUE STAR LN
PERRIS CA
92570-5210
US

V. Phone/Fax

Practice location:
  • Phone: 951-466-3196
  • Fax:
Mailing address:
  • Phone: 760-620-6724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: