Individual provider Active NPI

Linda J. Marcoux, EDDCP, MFT

  • Marriage & Family Therapist
  • Crestline, CA
National Provider Identifier
1013103068
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 47598 Issued in CA
Practice address
23451 Crest Forest Dr.
Crestline, CA 92325
Phone
(760) 961-7733
Fax
(760) 961-7733
NPI assigned
Sep 22, 2007
Last updated
May 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC47598 CA
Marriage & Family Therapist 106H00000X MFC 47598 CA Primary

Addresses

Primary practice location

23451 Crest Forest Dr.
Crestline, CA 92325

Mailing address

18031 US Highway 18 Ste E
Apple Valley, CA 92307-2152
Phone (760) 961-7733

Other practice location 1

11951 Hesperia Rd
Hesperia, CA 92345-1855
Phone (760) 956-2434

Other practice location 2

18031 US Highway 18 Ste E
Apple Valley, CA 92307-2152
Phone (760) 961-7733

Other practice location 3

18031 US Highway 18 Ste E
Apple Valley, CA 92307-2152
Phone (760) 961-7733

Other practice location 4

23720 Lake Dr.
Crestline, CA 92325
Phone (760) 961-7733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC 47598CAMDMarriage & Family Therapist
MFC47598CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1013103068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18031 US HIGHWAY 18 STE E",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072152",
            "telephone_number": "760-961-7733",
            "fax_number": "760-961-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23451 CREST FOREST DR.",
            "city": "CRESTLINE",
            "state": "CA",
            "postal_code": "92325",
            "telephone_number": "760-961-7733",
            "fax_number": "760-961-7733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11951 Hesperia Rd",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923451855",
            "country_code": "US",
            "telephone_number": "760-956-2434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18031 US Highway 18 Ste E",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072152",
            "country_code": "US",
            "telephone_number": "760-961-7733",
            "fax_number": "760-961-7733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18031 US Highway 18 Ste E",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072152",
            "country_code": "US",
            "telephone_number": "760-961-7733",
            "fax_number": "760-961-7733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23720 Lake Dr.",
            "address_purpose": "LOCATION",
            "city": "Crestline",
            "state": "CA",
            "postal_code": "92325",
            "country_code": "US",
            "telephone_number": "760-961-7733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCOUX",
        "first_name": "LINDA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "EDDCP, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-22",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC47598",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 47598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestline, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.