MEDICARE: DR. LINDA HOPKINS

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	251S00000X	Community/Behavioral Health Agency	PSY 17912	CA
2	302F00000X	Exclusive Provider Organization	PSY 17912	CA
3	302R00000X	Health Maintenance Organization	PSY 17912	CA
4	305S00000X	Point of Service	PSY 17912	CA
5	305R00000X	Preferred Provider Organization	PSY 17912	CA

General Provider Information

NPI Number	:	1629488721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. LINDA HOPKINS

Provider Business Mailing Address
First Line	:	3471 VIA LIDO
Second Line	:	SUITE 209
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3912
Country	:	US
Telephone Number	:	949-290-2102
Fax Number	:

Provider Business Practice Location Address
First Line	:	3471 VIA LIDO
Second Line	:	SUITE 209
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3912
Country	:	US
Telephone Number	:	949-290-2102
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL PSYCHOLOGIST
Name	:	DR. LINDA C. HOPKINS
Credential	:	PSY 17912
Telephone Number	:	949-290-2102

Provider Enumeration Date	:	04/29/2014
Last Update Date	:	04/29/2014

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