Healthcare Provider Details

I. General information

NPI: 1649586587
Provider Name (Legal Business Name): LINDA HARDIN LCSW, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29645 RANCHO CALIFORNIA RD 238
TEMECULA CA
92591-6200
US

IV. Provider business mailing address

29645 RANCHO CALIFORNIA RD 238
TEMECULA CA
92591-6200
US

V. Phone/Fax

Practice location:
  • Phone: 951-676-3455
  • Fax: 951-693-1010
Mailing address:
  • Phone: 951-676-3455
  • Fax: 951-693-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS10802
License Number StateCA

VIII. Authorized Official

Name: MRS. LINDA MARIE HARDIN
Title or Position: CEO
Credential: M.S.W.
Phone: 951-676-3455