Healthcare Provider Details

I. General information

NPI: 1225021926
Provider Name (Legal Business Name): LINDA O. FOLSOM PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL, CAMP PENDLETON BLDG H100
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

5126 BELLA COLLINA ST
OCEANSIDE CA
92056-1903
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-1555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 14548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: