Provider Demographics
NPI:1902672363
Name:REYNA, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:REYNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4139 EL CAMINO WAY
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-4010
Mailing Address - Country:US
Mailing Address - Phone:626-831-5433
Mailing Address - Fax:
Practice Address - Street 1:4139 EL CAMINO WAY
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-4010
Practice Address - Country:US
Practice Address - Phone:626-831-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No171M00000XOther Service ProvidersCase Manager/Care Coordinator