Basic Information
| Provider Information | |||||||||
| NPI: | 1548763956 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALCALA | ||||||||
| FirstName: | LINDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11951 HESPERIA RD | ||||||||
| Address2: | |||||||||
| City: | HESPERIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923451855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7609562345 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11951 HESPERIA RD | ||||||||
| Address2: | |||||||||
| City: | HESPERIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923451855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7609562345 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2018 | ||||||||
| LastUpdateDate: | 08/20/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | IMF94018 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 117140 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.