Provider Demographics
NPI:1902009673
Name:REGAN, LINDA DIANE (LCSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:DIANE
Last Name:REGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 PLAYER CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-3293
Mailing Address - Country:US
Mailing Address - Phone:661-872-4731
Mailing Address - Fax:
Practice Address - Street 1:4212 PLAYER CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-3293
Practice Address - Country:US
Practice Address - Phone:661-872-4731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS283831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical