Basic Information
| Provider Information | |||||||||
| NPI: | 1265563233 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINSCOTT | ||||||||
| FirstName: | ALEXANDRA | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 9TH ST | ||||||||
| Address2: | ROOM 150 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958146414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166519475 | ||||||||
| FaxNumber: | 9166518908 | ||||||||
| Practice Location | |||||||||
| Address1: | 3102 E. HIGHLAND AVENUE | ||||||||
| Address2: | MEDICAL STAFF OFFICE | ||||||||
| City: | PATTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094257679 | ||||||||
| FaxNumber: | 9094256635 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 08/09/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 103TC0700X | PSY25715 | CA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 7068 | 05 | CA | MEDICAID | 7420 | 05 | CA | MEDICAID |