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General NPI Number Information
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NPI Number | 1174744502
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Entity Type | Individual
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Provider Name | LINDA JAMES MYERS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 ADMIRAL DR # B386
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City | EMERYVILLE
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State | CA
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Zip | 94608-1550
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Country | US
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Telephone | 510-601-1789
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Fax | 415-865-2636
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Provider Business Mailing Address
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Address Line | 5800 SUNBURY RD
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City | GAHANNA
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State | OH
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Zip | 43230-1152
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Country | US
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Telephone | 614-218-1186
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Fax | 510-601-1789
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2035
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License Number State | OH
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