Provider Demographics
NPI:1477625572
Name:GORIN-SIBNER, LINDA CAROL (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:CAROL
Last Name:GORIN-SIBNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:CAROL
Other - Last Name:SIBNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3709 VIA LA SELVA
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1117
Mailing Address - Country:US
Mailing Address - Phone:310-784-7170
Mailing Address - Fax:310-791-8656
Practice Address - Street 1:4560 ADMIRALTY WAY
Practice Address - Street 2:SUITE 302
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5423
Practice Address - Country:US
Practice Address - Phone:310-784-7170
Practice Address - Fax:310-791-8656
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10452103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical