Provider Demographics
NPI:1053802116
Name:HARTMAN, LINDA LETIZIA (LVN)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:LETIZIA
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 W TAYLOR ST SPC 376
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-1054
Mailing Address - Country:US
Mailing Address - Phone:818-237-7658
Mailing Address - Fax:
Practice Address - Street 1:519 W TAYLOR ST SPC 376
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-1054
Practice Address - Country:US
Practice Address - Phone:818-237-7658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA265484164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse