Healthcare Provider Details

I. General information

NPI: 1427087337
Provider Name (Legal Business Name): LINDA L TAGGART LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 COLLEGE AVE
BERKELEY CA
94705-2755
US

IV. Provider business mailing address

1400 SHATTUCK AVE STE 12 BOX 216
BERKELEY CA
94709-1474
US

V. Phone/Fax

Practice location:
  • Phone: 650-469-3617
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number077484-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 27170
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: