Provider Demographics
NPI:1538532288
Name:WHITE, LINDA (MS LMFT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4873
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93007-0873
Mailing Address - Country:US
Mailing Address - Phone:805-509-7762
Mailing Address - Fax:
Practice Address - Street 1:1068 E MAIN ST
Practice Address - Street 2:SUITE 230A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-3091
Practice Address - Country:US
Practice Address - Phone:805-509-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86790106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist