Basic Information
| Provider Information | |||||||||
| NPI: | 1881727931 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOK | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | RN217145 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1051 MILLET WAY | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958341446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9169256520 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 A ST | ||||||||
| Address2: | |||||||||
| City: | DAVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956163649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307575530 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 07/12/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 217145 | CA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.