| Doctor Name: | LINDA R PARK |
| NPI Number: | 1245203538 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | LCS2594 |
| Business Practice Address: | 100 Avram Ste 203b Rohnert Park, CA - 94928 |
| Business Phone Number: | 7077951599 |
| Business Fax Number: | 7077921600 |
| Mailing Address: | 1265 Camino Coronado, ROHNERT PARK |
| State: | CA |
| Postal Code: | 94928 |
| Phone Number: | 7077951590 |
| Fax Number: | 7077921600 |
| NPI Enumeration Date: | 02/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCS2594 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |