Linda Marie Haack, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY12334 Issued in CA

Practice address

23823 Malibu Rd # 50-437
Malibu, CA 90265-4628

Phone

(858) 451-0771

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Linda Marie Haack-Rogers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 26, 2023 through Oct 26, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705795200000",
    "number": "1447303540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23823 MALIBU RD # 50-437",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654628",
            "telephone_number": "858-451-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23823 MALIBU RD # 50-437",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654628",
            "telephone_number": "858-451-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAACK",
        "first_name": "LINDA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2024-01-21",
        "certification_date": "2024-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "HAACK-ROGERS",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Grasshopper House, LLC
• Sage Grazer
• Adam Dov Greenberg, L. AC.
• Lauren M Greenman, PA-C
• Christiana Dorian Grotlisch, LCSW
• Evan Rhys Haines, PSYD
• Anthony John Hall, D.C.
• Kristy Lynn Hamilton, LCSW
• Karen Hannigan, M.S., CCC-SLP
• Anita Borg Hansen, D.C.

• Clinical Psychologist in Malibu, CA
• Providers in Malibu, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.