Healthcare Provider Details

I. General information

NPI: 1750809703
Provider Name (Legal Business Name): DIANA MERCY LINARES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14129 BUCHER AVE
SYLMAR CA
91342-1442
US

IV. Provider business mailing address

14129 BUCHER AVE
SYLMAR CA
91342-1442
US

V. Phone/Fax

Practice location:
  • Phone: 310-221-6336
  • Fax:
Mailing address:
  • Phone: 310-221-6336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number83644
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberACSW122201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: