Basic Information
Provider Information
NPI: 1457445793
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KLIEMAN
FirstName: LINDA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2350 W. EL CAMINO REAL
Address2: 2ND FLOOR
City: MOUNTAIN VIEW
State: CA
PostalCode: 940406203
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 795 EL CAMINO REAL
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943012302
CountryCode: US
TelephoneNumber: 6503214121
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/03/2006
LastUpdateDate: 03/16/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XNP488129CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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