Provider Demographics
NPI:1295741569
Name:BAHNSON, LINDA WEISS (MFT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:WEISS
Last Name:BAHNSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:PARRISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYCHOLOGIST LICENSE
Mailing Address - Street 1:125 E BARSTOW
Mailing Address - Street 2:#109
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-485-1978
Mailing Address - Fax:559-485-1978
Practice Address - Street 1:125 E BARSTOW
Practice Address - Street 2:109
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721
Practice Address - Country:US
Practice Address - Phone:559-485-1978
Practice Address - Fax:559-485-1978
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC17209103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist