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NPI Code Detail

MEDICARE: LYNDA KOLIBA LMFT

MEDICARE:   LYNDA  KOLIBA  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist124411CA

General Provider Information

NPI Number : 1164017257
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNDA KOLIBA LMFT
Provider Business Mailing Address
First Line : 9084 LA CRESCENTA AVE
Second Line :
City : FOUNTAIN VALLEY
State : CA
Zip : 92708-4460
Country : US
Telephone Number : 714-883-8245
Fax Number :
Provider Business Practice Location Address
First Line : 601 S HARBOR BLVD
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-4521
Country : US
Telephone Number : 714-883-8245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2021
Last Update Date : 05/12/2025

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