Provider Demographics
NPI:1669756995
Name:ROSS, LINDA M (LCSW)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:ROSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:595 E COLORADO BLVD STE 533
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-5223
Mailing Address - Country:US
Mailing Address - Phone:626-568-3457
Mailing Address - Fax:
Practice Address - Street 1:595 E COLORADO BLVD STE 533
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-5223
Practice Address - Country:US
Practice Address - Phone:626-568-3457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS14500171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator