Provider Demographics
NPI:1164252458
Name:RANKIN, LINDA ABIGAIL (AMFT #148140)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ABIGAIL
Last Name:RANKIN
Suffix:
Gender:F
Credentials:AMFT #148140
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 OTAY LAKES RD STE 502-250
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-1004
Mailing Address - Country:US
Mailing Address - Phone:619-213-3610
Mailing Address - Fax:
Practice Address - Street 1:3103 FALCON ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5472
Practice Address - Country:US
Practice Address - Phone:619-320-5407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health