Individual
LINDA LONGSTREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10 EVERGREEN AVE, MILL VALLEY, CA 94941-5601
(415) 388-4203
Mailing address
10 EVERGREEN AVE, MILL VALLEY, CA 94941-5601
(415) 388-4203
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
222981
CA
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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