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NPI Code Detail

MEDICARE: DR. LINDA MARIE GROSSMAN PH.D.

MEDICARE:  DR. LINDA MARIE GROSSMAN  PH.D.
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
1103T00000XPsychologistPSY8700CA

General Provider Information

NPI Number : 1417005570
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA MARIE GROSSMAN PH.D.
Provider Business Mailing Address
First Line : 25255 CABOT RD STE 210
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-5508
Country : US
Telephone Number : 949-770-2244
Fax Number : 949-770-2440
Provider Business Practice Location Address
First Line : 25255 CABOT RD STE 210
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-5508
Country : US
Telephone Number : 949-770-2244
Fax Number : 949-770-2440
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/08/2007

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Directions to “ DR. LINDA MARIE GROSSMAN PH.D.” Practice Location

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