Provider Demographics
NPI:1578804829
Name:MORSE, LINDA L
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:L
Last Name:MORSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2050
Mailing Address - Street 2:
Mailing Address - City:PENN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95946-2050
Mailing Address - Country:US
Mailing Address - Phone:530-277-9750
Mailing Address - Fax:530-432-6926
Practice Address - Street 1:21962 MCDANIEL RD
Practice Address - Street 2:
Practice Address - City:BIG OAK VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95977-9504
Practice Address - Country:US
Practice Address - Phone:530-277-9750
Practice Address - Fax:530-432-6926
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARS7016101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)