Provider Demographics
NPI:1245589316
Name:LINARES, LOGAN JAMES (MS, MFTI)
Entity Type:Individual
Prefix:MR
First Name:LOGAN
Middle Name:JAMES
Last Name:LINARES
Suffix:
Gender:M
Credentials:MS, MFTI
Other - Prefix:MR
Other - First Name:LOGAN
Other - Middle Name:JAMES
Other - Last Name:LINARES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS MFTI
Mailing Address - Street 1:6615 VALLEY HI DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-7076
Mailing Address - Country:US
Mailing Address - Phone:916-681-6300
Mailing Address - Fax:
Practice Address - Street 1:6615 VALLEY HI DR
Practice Address - Street 2:SUITE A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-7076
Practice Address - Country:US
Practice Address - Phone:916-681-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76065106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist