Healthcare Provider Details

I. General information

NPI: 1366560682
Provider Name (Legal Business Name): LAURA J LINTON BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4283 EL CAJON BLVD STE 115
SAN DIEGO CA
92105-1289
US

IV. Provider business mailing address

10353 AZUAGA ST #109
SAN DIEGO CA
92129-4090
US

V. Phone/Fax

Practice location:
  • Phone: 619-521-7609
  • Fax: 619-393-0242
Mailing address:
  • Phone: 858-538-8747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: