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Individual

DR. JERRY ERNEST LINDQUIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., OTR/L

Contact information

Practice address
8699 HOLDER ST, BUENA PARK, CA 90620-3614
(714) 563-6556
(714) 821-5683
Mailing address
8699 HOLDER ST, BUENA PARK, CA 90620-3614
(714) 563-6556
(714) 821-5683

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 11789
CA
225X00000X
Occupational Therapist
OT 5173
CA

Other

Enumeration date
10/15/2010
Last updated
10/15/2010
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