Provider Demographics
NPI:1265692198
Name:REED, LINDA DIANE (DPT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:DIANE
Last Name:REED
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2315 KUEHNER DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3900
Mailing Address - Country:US
Mailing Address - Phone:805-823-8200
Mailing Address - Fax:805-823-8208
Practice Address - Street 1:2315 KUEHNER DR
Practice Address - Street 2:SUITE 115
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3900
Practice Address - Country:US
Practice Address - Phone:805-823-8200
Practice Address - Fax:805-823-8208
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT6095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABJ683ZMedicare PIN