Provider Demographics
NPI:1083779961
Name:MCFADDEN, LINDA (LCSW MFCC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:LCSW MFCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17411 IRVINE BLVD
Mailing Address - Street 2:SUITE K
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3039
Mailing Address - Country:US
Mailing Address - Phone:714-832-5775
Mailing Address - Fax:
Practice Address - Street 1:17411 IRVINE BLVD
Practice Address - Street 2:SUITE K
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3039
Practice Address - Country:US
Practice Address - Phone:714-832-5775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 32741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical