Linda Marie Gendron, LCSW
Individual provider Active NPI Social Worker · Grover Beach, CA
NPI 1104398155 · NPPES record last updated Feb 8, 2024
Key facts
- NPI
- 1104398155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LCSW99052 (CA)
- Practice address
- 657 Trouville Ave #2
Grover Beach, CA 93433 - Phone
- (805) 474-2165
- Fax
- (805) 474-2160
- NPI assigned
- Dec 31, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW73630 | CA | MD | Social Worker |
| LCSW99052 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Luis Obispo Drug and Alcohol Services | Past | Accepting new patients | |
| County of San Luis Obispo | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | ASW73630 | CA | |
| Social Worker | 104100000X | LCSW99052 | CA | Yes |
Addresses
Primary practice location
657 Trouville Ave #2
Grover Beach, CA 93433
Mailing address
657 Trouville Ave. #2
Grover Beach, CA 93433
Phone (805) 474-2165
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104100000X | Other | BOARD OF BEHAVIORAL SCIENCE |
Other providers in Grover Beach, CA
- Ginette Gallagher II
- Tessa Gallo
- Angela Trinidad Garcia Arenas
- Aurora Garcia
- Xaviera Garza
- Annika Gilbert
- Adelina Gill
- Shana Gitterman
- Kevin Michal Andrew Goodman
- Spencer Goss
All providers in Grover Beach, CA · Social Worker in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.