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NPI 1285142059

NPI 1285142059 : WAN-NING LINDA LO LMFT : CERRITOS, CA

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General NPI Number Information
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    NPI Number           |    1285142059
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    Entity Type          |    Individual 
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    Provider Name        |    WAN-NING LINDA LO LMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/16/2018
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    Last Update Date     |    08/17/2023
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Provider Practice Location Address
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    Address Line         |    12900 PARK PLAZA DR 
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    City                 |    CERRITOS
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    State                |    CA
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    Zip                  |    90703-9329
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    Country              |    US
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    Telephone            |    558-188-8204
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 8522 
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    City                 |    ROWLAND HEIGHTS
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    State                |    CA
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    Zip                  |    91748-0522
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    Country              |    US
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    Telephone            |    909-655-8146
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    Fax                  |    
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    116342
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    225400000X
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    Taxonomy Name        |    Rehabilitation Practitioner
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #5
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    128294
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    License Number State |    CA
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