Linda Diane Eberth, PHD CLINICAL PSYCHOL

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY13672 Issued in CA

Practice address

12301 Wilshire Blvd
Suite 210
West Los Angeles, CA 90025

Phone

(310) 314-1858

Fax

(310) 314-1848

NPI assigned

Apr 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083736250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD",
            "address_2": "SUITE 210",
            "city": "WEST LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-314-1858",
            "fax_number": "310-314-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD",
            "address_2": "SUITE 210",
            "city": "WEST LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-314-1858",
            "fax_number": "310-314-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERTH",
        "first_name": "LINDA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PHD CLINICAL PSYCHOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY13672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OPL136720",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "OPL136721",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allan J. Comeau, PH.D.
• Shelby Rose Condon
• Bianca M Daalder, MFT
• Stephanie Mitsuye Dacay, R.D.
• Gili Dekel
• Suzanne R. Ecker, MFT
• Embodied Wellness and Recovery, P.C.
• Jayne Pamela Fritz, RD
• Anne Galbraith, MFT
• Akashdeep Singh Gill, M.D.

• Clinical Psychologist in West Los Angeles, CA
• Providers in West Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.