Provider Demographics
NPI:1538310115
Name:MOLINA, LINDA ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:MOLINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:MOLINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1030 W WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3147
Mailing Address - Country:US
Mailing Address - Phone:714-834-6915
Mailing Address - Fax:714-850-1066
Practice Address - Street 1:1030 W WARNER AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3147
Practice Address - Country:US
Practice Address - Phone:714-834-6915
Practice Address - Fax:714-850-1066
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 15450104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker