Healthcare Provider Details

I. General information

NPI: 1831460468
Provider Name (Legal Business Name): LINDA RENE FRAZIER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 12/27/2023
Certification Date: 12/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28693 OLD TOWN FRONT ST STE 300F
TEMECULA CA
92590-2786
US

IV. Provider business mailing address

28693 OLD TOWN FRONT ST STE 300F
TEMECULA CA
92590-2786
US

V. Phone/Fax

Practice location:
  • Phone: 951-249-3436
  • Fax:
Mailing address:
  • Phone: 951-249-3436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY33134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: