Healthcare Provider Details

I. General information

NPI: 1194044198
Provider Name (Legal Business Name): LINDA LYNES LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 N EUCLID ST STE 500
ANAHEIM CA
92801-1900
US

IV. Provider business mailing address

1188 N EUCLID ST STE 500
ANAHEIM CA
92801-1900
US

V. Phone/Fax

Practice location:
  • Phone: 714-644-6480
  • Fax:
Mailing address:
  • Phone: 714-644-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMFC84399
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC84399
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: