Provider Demographics
NPI:1710186754
Name:PARKER, LINDA S (MFT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:S
Last Name:PARKER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28342 BURNS AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-5006
Mailing Address - Country:US
Mailing Address - Phone:909-425-2277
Mailing Address - Fax:
Practice Address - Street 1:28342 BURNS AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-5006
Practice Address - Country:US
Practice Address - Phone:909-425-2277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC19684106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist