Provider Demographics
NPI:1083750723
Name:BROOKS, LINDA MARIE (MFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MFT
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 892014
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92589
Mailing Address - Country:US
Mailing Address - Phone:951-600-6355
Mailing Address - Fax:
Practice Address - Street 1:41002 COUNTY CENTER DR #320
Practice Address - Street 2:TEMECULA MENTAL HEALTH
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591
Practice Address - Country:US
Practice Address - Phone:951-600-6355
Practice Address - Fax:951-600-6365
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36259106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist