Provider Demographics
NPI:1548534019
Name:EPSTEIN-GRAVAL, LINDA X (MFT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:EPSTEIN-GRAVAL
Suffix:X
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31285 CORTE RIMOLA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-3643
Mailing Address - Country:US
Mailing Address - Phone:951-331-1274
Mailing Address - Fax:
Practice Address - Street 1:31285 CORTE RIMOLA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-3643
Practice Address - Country:US
Practice Address - Phone:951-331-1274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22871106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist