Provider Demographics
NPI:1982650149
Name:HARDWICK, LINDA RAE (MSW)
Entity Type:Individual
Prefix:
First Name:LINDA RAE
Middle Name:
Last Name:HARDWICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 GOLDEN RAIN RD
Mailing Address - Street 2:#13
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-1985
Mailing Address - Country:US
Mailing Address - Phone:925-708-2921
Mailing Address - Fax:925-952-4173
Practice Address - Street 1:1110 BURNETT AVE
Practice Address - Street 2:SUITE J
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5634
Practice Address - Country:US
Practice Address - Phone:925-708-2921
Practice Address - Fax:925-952-4173
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA218761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical