Provider Demographics
NPI:1699803056
Name:HUCKABEE, LINDA K (OTR)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:HUCKABEE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 VERIN LN
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7830
Mailing Address - Country:US
Mailing Address - Phone:619-482-0839
Mailing Address - Fax:
Practice Address - Street 1:10159 MISSION GORGE RD
Practice Address - Street 2:SUITE AB
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3857
Practice Address - Country:US
Practice Address - Phone:619-596-4042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1948225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist