Provider Demographics
NPI:1093748147
Name:CALVIN, LINDA L (LMFT RAS)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:L
Last Name:CALVIN
Suffix:
Gender:F
Credentials:LMFT RAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31-601 BOB HOPE DRIVE STE E-5
Mailing Address - Street 2:BOX 411
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270
Mailing Address - Country:US
Mailing Address - Phone:760-837-9480
Mailing Address - Fax:760-837-3961
Practice Address - Street 1:41-750 RANCHO LAS PALMAS
Practice Address - Street 2:D-2
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270
Practice Address - Country:US
Practice Address - Phone:760-837-9480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32506101YM0800X
CACA32506106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health