Provider Demographics
NPI:1154560423
Name:LIN, HOWARD K (PSYD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:K
Last Name:LIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16755 VON KARMAN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-4963
Mailing Address - Country:US
Mailing Address - Phone:714-202-6818
Mailing Address - Fax:
Practice Address - Street 1:16755 VON KARMAN AVE STE 200
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-4963
Practice Address - Country:US
Practice Address - Phone:714-202-6818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30811103T00000X, 103T00000X, 103T00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program