=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417007857
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDA B HASKETT PH.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3641 SACRAMENTO ST SUITE J
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94118-1722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-409-0850
-----------------------------------------------------
Fax | 707-554-0529
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3641 SACRAMENTO ST SUITE J
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94118-1722
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-409-0850
-----------------------------------------------------
Fax | 707-554-0529
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | PSY9781
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------