Provider Demographics
NPI:1699706069
Name:GERNER, LINDA MC (DC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MC
Last Name:GERNER
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:MC
Other - Last Name:GERNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1403 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-3900
Mailing Address - Country:US
Mailing Address - Phone:415-713-4341
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:2043 ANDERSON RD
Practice Address - Street 2:SUITE D
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-0676
Practice Address - Country:US
Practice Address - Phone:415-713-4341
Practice Address - Fax:866-433-3034
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29762111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0297620OtherBLUE SHIELD
CADC29762OtherCHIRORPRACTIC LICENSE
CADC0297620OtherPTAN