Basic Information
Provider Information
NPI: 1396942355
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHITMAN FLAMM
FirstName: LINDA
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: PSY
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3200 ADELINE ST
Address2:  
City: BERKELEY
State: CA
PostalCode: 947032407
CountryCode: US
TelephoneNumber: 5106010203
FaxNumber: 5106014002
Practice Location
Address1: 3200 ADELINE ST
Address2:  
City: BERKELEY
State: CA
PostalCode: 947032407
CountryCode: US
TelephoneNumber: 5106010203
FaxNumber: 5106014002
Other Information
ProviderEnumerationDate: 07/02/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X14674CAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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