Provider Demographics
NPI:1083702831
Name:LEVITON, LINDA POWERS (MA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:POWERS
Last Name:LEVITON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33993
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91394-3993
Mailing Address - Country:US
Mailing Address - Phone:818-203-5987
Mailing Address - Fax:818-831-0183
Practice Address - Street 1:10538 BALCOM AVE
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5905
Practice Address - Country:US
Practice Address - Phone:818-203-5987
Practice Address - Fax:818-831-0183
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35504106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist