Provider Demographics
NPI:1588986194
Name:EMERY, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:EMERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DBA: BAYSPORT
Other - Middle Name:THERAPY
Other - Last Name:SERVICES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:987 UNIVERSITY AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-7640
Mailing Address - Country:US
Mailing Address - Phone:408-395-7300
Mailing Address - Fax:408-395-7350
Practice Address - Street 1:12000 CARMEL COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6101
Practice Address - Country:US
Practice Address - Phone:858-509-9600
Practice Address - Fax:858-509-9611
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT34647225100000X
CA26599225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist