Provider Demographics
NPI:1801998596
Name:CROOKS, LINDA DIANE (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:DIANE
Last Name:CROOKS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 WILSHIRE BLVD
Mailing Address - Street 2:607
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5808
Mailing Address - Country:US
Mailing Address - Phone:310-828-7450
Mailing Address - Fax:310-399-5503
Practice Address - Street 1:2444 WILSHIRE BLVD
Practice Address - Street 2:607
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5808
Practice Address - Country:US
Practice Address - Phone:310-828-7450
Practice Address - Fax:310-399-5503
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11147103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical