Provider Demographics
NPI:1861656944
Name:LIN, OLIVER S (PHD)
Entity Type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:S
Last Name:LIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:866 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-8580
Mailing Address - Country:US
Mailing Address - Phone:650-723-3785
Mailing Address - Fax:650-725-2887
Practice Address - Street 1:866 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-8580
Practice Address - Country:US
Practice Address - Phone:650-723-3785
Practice Address - Fax:650-725-2887
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21598103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical