Provider Demographics
NPI:1215484472
Name:LINDE, TONYA
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:LINDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58945 BUSINESS CENTER DR STE N
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-7310
Mailing Address - Country:US
Mailing Address - Phone:760-369-1074
Mailing Address - Fax:760-369-1293
Practice Address - Street 1:58945 BUSINESS CENTER DR STE N
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-7310
Practice Address - Country:US
Practice Address - Phone:760-369-1074
Practice Address - Fax:760-369-1293
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator