Provider Demographics
NPI:1881867661
Name:SHULMAN, LINDA (MA)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SHULMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6613 BAYBERRY ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-1328
Mailing Address - Country:US
Mailing Address - Phone:818-577-3342
Mailing Address - Fax:818-865-1152
Practice Address - Street 1:30423 CANWOOD ST
Practice Address - Street 2:SUITE 214
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2082
Practice Address - Country:US
Practice Address - Phone:818-577-3342
Practice Address - Fax:818-865-1152
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC25843106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist