Provider Demographics
NPI:1841323730
Name:FARLEY, LINDA H (MFT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:H
Last Name:FARLEY
Suffix:
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 1:1447 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5008
Mailing Address - Country:US
Mailing Address - Phone:530-888-7958
Mailing Address - Fax:530-888-7999
Practice Address - Street 1:1447 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95603-5008
Practice Address - Country:US
Practice Address - Phone:530-888-7958
Practice Address - Fax:530-888-7999
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC9250101Y00000X, 101YA0400X, 101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11765651OtherCAQH