=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316080807
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDA ANKENEY M.A.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2007
-----------------------------------------------------
Last Update Date | 01/30/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1380 LEAD HILL BLVD SUITE 160
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95661-2941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-885-6161
-----------------------------------------------------
Fax | 916-676-0543
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11811 CARAMAY WAY
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95602-7702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-885-6161
-----------------------------------------------------
Fax | 916-676-0543
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFC 48267
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------