Provider Demographics
NPI:1184790230
Name:LINN, DIANA JO (MFT)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:JO
Last Name:LINN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 CROSSINGS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-3932
Mailing Address - Country:US
Mailing Address - Phone:650-630-3950
Mailing Address - Fax:
Practice Address - Street 1:5406 CROSSINGS DR STE 102
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-3932
Practice Address - Country:US
Practice Address - Phone:650-630-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37771106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6333OtherSANTA CLARA CO. MEDICAL