Provider Demographics
NPI:1205032208
Name:FISHERMAN, LINDA ROBIN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ROBIN
Last Name:FISHERMAN
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 1:699 HAMPSHIRE ROAD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361
Mailing Address - Country:US
Mailing Address - Phone:805-374-1770
Mailing Address - Fax:805-374-1774
Practice Address - Street 1:699 HAMPSHIRE ROAD
Practice Address - Street 2:SUITE 20
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:805-374-1770
Practice Address - Fax:805-374-1774
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37732106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist