Provider Demographics
NPI:1669687745
Name:RYAN, LINDA KAREN (LMFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAREN
Last Name:RYAN
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 1:2143 HURLEY WAY STE 240
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-3299
Mailing Address - Country:US
Mailing Address - Phone:916-440-0889
Mailing Address - Fax:
Practice Address - Street 1:2143 HURLEY WAY STE 240
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-3299
Practice Address - Country:US
Practice Address - Phone:916-440-0889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC44482106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist