Provider Demographics
NPI:1417947235
Name:ALTES, LINDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:ALTES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 EXECUTIVE DR
Mailing Address - Street 2:STE. 255
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2115
Mailing Address - Country:US
Mailing Address - Phone:858-824-1914
Mailing Address - Fax:858-824-1916
Practice Address - Street 1:4350 EXECUTIVE DR
Practice Address - Street 2:STE. 255
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2115
Practice Address - Country:US
Practice Address - Phone:858-824-1914
Practice Address - Fax:858-824-1916
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11113103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist