Healthcare Provider Details

I. General information

NPI: 1871297937
Provider Name (Legal Business Name): LINN THERAPY A PROFESSIONAL LICENSED CLINICAL SOCIAL WORKER CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 03/30/2023
Certification Date: 03/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26501 BRIAN PLACE
BEAR VALLEY SPRINGS CA
93561
US

IV. Provider business mailing address

4231 BALBOA AVE # 1020
SAN DIEGO CA
92117-5504
US

V. Phone/Fax

Practice location:
  • Phone: 858-206-8650
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AUDRA LINN
Title or Position: OWNER & CEO
Credential:
Phone: 858-206-8650