Provider Demographics
NPI:1831200716
Name:LINTON, BRUCE (MA PHD MFT)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:LINTON
Suffix:
Gender:M
Credentials:MA PHD MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521A SHATTUCK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1516
Mailing Address - Country:US
Mailing Address - Phone:510-644-0300
Mailing Address - Fax:510-845-8530
Practice Address - Street 1:1521A SHATTUCK AVE STE 201
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-1516
Practice Address - Country:US
Practice Address - Phone:510-644-0300
Practice Address - Fax:510-845-8530
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 14092106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist