Provider Demographics
NPI:1699339077
Name:LIN, AMY T (PHD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:T
Last Name:LIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 E LAMBERT RD STE 108
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4300
Mailing Address - Country:US
Mailing Address - Phone:909-837-7665
Mailing Address - Fax:
Practice Address - Street 1:1800 E LAMBERT RD STE 108
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4300
Practice Address - Country:US
Practice Address - Phone:909-837-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21269103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical