Healthcare Provider Details

I. General information

NPI: 1326155516
Provider Name (Legal Business Name): LINDA SUE AH SAM FNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 RICHLAND ROAD
YUBA CA
95991
US

IV. Provider business mailing address

810 RICHLAND ROAD
YUBA CA
95991
US

V. Phone/Fax

Practice location:
  • Phone: 530-755-0464
  • Fax: 530-751-8514
Mailing address:
  • Phone: 530-755-0464
  • Fax: 530-751-8514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN351787
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: