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NPI Code Detail

MEDICARE: MS. LINDA ANN MARX MSW

MEDICARE:  MS. LINDA ANN MARX  MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker12108CA
2101YA0400XAddiction (Substance Use Disorder) Counselor13489CA

General Provider Information

NPI Number : 1366553612
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA ANN MARX MSW
Provider Business Mailing Address
First Line : PO BOX 1666
Second Line :
City : PLACERVILLE
State : CA
Zip : 95667-1666
Country : US
Telephone Number : 530-642-1715
Fax Number : 530-642-2064
Provider Business Practice Location Address
First Line : 2844 COLOMA ST
Second Line :
City : PLACERVILLE
State : CA
Zip : 95667-4406
Country : US
Telephone Number : 530-642-1715
Fax Number : 530-642-2064
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 11/10/2014

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