Provider Demographics
NPI:1760816474
Name:MAKOVIC, LINDA (RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MAKOVIC
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8361 TERRY DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4938
Mailing Address - Country:US
Mailing Address - Phone:714-834-4568
Mailing Address - Fax:
Practice Address - Street 1:8361 TERRY DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4938
Practice Address - Country:US
Practice Address - Phone:714-834-4568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN429106101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health