Provider Demographics
NPI:1831317403
Name:DAVIS, LINDA SCOTT (MA, MFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:SCOTT
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11740 MONTANA AVE APT 407
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6749
Mailing Address - Country:US
Mailing Address - Phone:310-650-3631
Mailing Address - Fax:310-471-4996
Practice Address - Street 1:11740 MONTANA AVE APT 407
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-6749
Practice Address - Country:US
Practice Address - Phone:310-650-3631
Practice Address - Fax:310-471-4996
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-21
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32645106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist