Provider Demographics
NPI:1598811341
Name:COOK, LINDA ROSE (MA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ROSE
Last Name:COOK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1683 N SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-3267
Mailing Address - Country:US
Mailing Address - Phone:714-685-8862
Mailing Address - Fax:
Practice Address - Street 1:202 W LINCOLN AVE
Practice Address - Street 2:SUITE F
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865
Practice Address - Country:US
Practice Address - Phone:714-633-6423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT27695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health