MEDICARE: DR. LINDA ANN GOURLEY PH.D., PA-C

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
1	103G00000X	Clinical Neuropsychologist	PSY13334	CA
2	103TB0200X	Cognitive & Behavioral Psychologist	PSY13334	CA
3	103TC0700X	Clinical Psychologist	PSY13334	CA
4	103TH0004X	Health Psychologist	PSY13334	CA
5	363A00000X	Physician Assistant	PA11286	CA

General Provider Information

NPI Number	:	1558584912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA ANN GOURLEY PH.D., PA-C

Provider Business Mailing Address
First Line	:	3527 SACRAMENTO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1884
Country	:	US
Telephone Number	:	415-436-0330
Fax Number	:	415-753-1601

Provider Business Practice Location Address
First Line	:	3527 SACRAMENTO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1884
Country	:	US
Telephone Number	:	415-436-0330
Fax Number	:	415-753-1601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	09/11/2025

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