Healthcare Provider Details

I. General information

NPI: 1750437711
Provider Name (Legal Business Name): LINDA SUE POSTMA RDHAP,RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18853 MANZANITA DR. B
TWAIN HARTE CA
95383
US

IV. Provider business mailing address

PO BOX 1424
TWAIN HARTE CA
95383-1424
US

V. Phone/Fax

Practice location:
  • Phone: 209-988-1988
  • Fax: 209-586-5398
Mailing address:
  • Phone: 209-988-1988
  • Fax: 209-586-5398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number16914
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number333
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: