1881765956 NPI number — DR. GERALD B LINDE PH.D., M.F.T.

Table of content: DR. GERALD B LINDE PH.D., M.F.T. (NPI 1881765956)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881765956 NPI number — DR. GERALD B LINDE PH.D., M.F.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LINDE
Provider First Name:
GERALD
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D., M.F.T.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LINDE
Provider Other First Name:
JED
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D., M.F.T.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1881765956
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 CATALINA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALINAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93901-1319
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-759-7670
Provider Business Mailing Address Fax Number:
831-424-4727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
344 SALINAS ST
Provider Second Line Business Practice Location Address:
SUITE 105C
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93901-2727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-759-7670
Provider Business Practice Location Address Fax Number:
831-424-4727
Provider Enumeration Date:
11/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC15961 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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