Provider Demographics
NPI:1871591917
Name:WOLFF, LINDA LOUISE (MA)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LOUISE
Last Name:WOLFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9506 CORSA WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3143
Mailing Address - Country:US
Mailing Address - Phone:209-957-9033
Mailing Address - Fax:209-957-9044
Practice Address - Street 1:9506 CORSA WAY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95212-3143
Practice Address - Country:US
Practice Address - Phone:209-957-9033
Practice Address - Fax:209-957-9044
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2177231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU2177Medicaid
CAAU0010350Medicaid