Healthcare Provider Details
I. General information
NPI: 1942323928
Provider Name (Legal Business Name): LINDA LOUISE BARNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
769 W BLAINE ST STE B
RIVERSIDE CA
92507-3970
US
IV. Provider business mailing address
769 W BLAINE ST STE B
RIVERSIDE CA
92507-3970
US
V. Phone/Fax
- Phone: 951-358-4705
- Fax: 951-358-4719
- Phone: 951-358-4705
- Fax: 951-358-4719
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: