Provider Demographics
NPI:1992929095
Name:MYERS, LINDA JOY (MFT)
Entity type:Individual
Prefix:DR
First Name:LINDA JOY
Middle Name:
Last Name:MYERS
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 1:1700 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2200
Mailing Address - Country:US
Mailing Address - Phone:510-524-3898
Mailing Address - Fax:510-582-3573
Practice Address - Street 1:1700 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2200
Practice Address - Country:US
Practice Address - Phone:510-524-3898
Practice Address - Fax:510-582-3573
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA018486106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist