Healthcare Provider Details

I. General information

NPI: 1265550909
Provider Name (Legal Business Name): MS. LINA KLEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 N EUCLID ST FL 5
ANAHEIM CA
92801-1900
US

IV. Provider business mailing address

1188 N EUCLID ST FL 5
ANAHEIM CA
92801-1900
US

V. Phone/Fax

Practice location:
  • Phone: 714-254-6866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberA22048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: