Provider Demographics
NPI:1609299635
Name:ALDANA, LINA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINA
Middle Name:M
Last Name:ALDANA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 POMPTON AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2945
Mailing Address - Country:US
Mailing Address - Phone:973-826-2206
Mailing Address - Fax:
Practice Address - Street 1:80 POMPTON AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2945
Practice Address - Country:US
Practice Address - Phone:973-826-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5112103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical