Provider Demographics
NPI:1134601057
Name:LINZA, SHELLI PATRICE
Entity type:Individual
Prefix:
First Name:SHELLI
Middle Name:PATRICE
Last Name:LINZA
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 1:2920 INLAND EMPIRE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-5565
Mailing Address - Country:US
Mailing Address - Phone:909-235-9875
Mailing Address - Fax:
Practice Address - Street 1:2920 INLAND EMPIRE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-5565
Practice Address - Country:US
Practice Address - Phone:909-235-9875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty