Provider Demographics
NPI:1407135197
Name:LEVSHIN, LINDA (MFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LEVSHIN
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 1:1575 E 17TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8506
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1575 E 17TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8506
Practice Address - Country:US
Practice Address - Phone:714-619-0239
Practice Address - Fax:714-619-0251
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC24547106H00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist