Provider Demographics
NPI:1659394278
Name:CHARKINS, LINDA J (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:CHARKINS
Suffix:
Gender:F
Credentials:LMFT
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 934
Mailing Address - Street 2:
Mailing Address - City:WRIGHTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:92397-0934
Mailing Address - Country:US
Mailing Address - Phone:909-798-7267
Mailing Address - Fax:760-249-5058
Practice Address - Street 1:537 CAJON ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373
Practice Address - Country:US
Practice Address - Phone:909-798-7267
Practice Address - Fax:760-249-5748
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22650106H00000X
CALMFT22650106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist