Provider Demographics
NPI:1760548135
Name:LINDEN, MICHAEL K (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
Last Name:LINDEN
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:32122 CAMINO CAPISTRANO
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-3734
Mailing Address - Country:US
Mailing Address - Phone:949-248-7411
Mailing Address - Fax:949-248-7511
Practice Address - Street 1:32122 CAMINO CAPISTRANO
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3734
Practice Address - Country:US
Practice Address - Phone:949-248-7411
Practice Address - Fax:949-248-7511
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY11788103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical