Provider Demographics
NPI:1154793198
Name:LINSE, JUDITH JOANNE (OT)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:JOANNE
Last Name:LINSE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22242 GERMAIN ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-0202
Mailing Address - Country:US
Mailing Address - Phone:818-983-4256
Mailing Address - Fax:
Practice Address - Street 1:22242 GERMAIN ST UNIT 6
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-0202
Practice Address - Country:US
Practice Address - Phone:818-983-4256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5642225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist