Provider Demographics
NPI:1326220336
Name:ROBERTSON, LINDA MAXWELL (MFT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MAXWELL
Last Name:ROBERTSON
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 1:22 LA CERRA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3809
Mailing Address - Country:US
Mailing Address - Phone:949-697-9153
Mailing Address - Fax:949-715-3076
Practice Address - Street 1:22 LA CERRA DR
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3809
Practice Address - Country:US
Practice Address - Phone:949-697-9153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44929106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist