Provider Demographics
NPI:1043388408
Name:LIN, MARIE KWAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:KWAN
Last Name:LIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:391 TAYLOR BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2294
Mailing Address - Country:US
Mailing Address - Phone:925-688-8910
Mailing Address - Fax:925-688-2100
Practice Address - Street 1:391 TAYLOR BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2294
Practice Address - Country:US
Practice Address - Phone:925-688-8910
Practice Address - Fax:925-688-2100
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY7621103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist