Provider Demographics
NPI:1437962289
Name:MACIAS PEREZ, LINDA JOCELYN
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:JOCELYN
Last Name:MACIAS PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1253 S TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90023-3326
Mailing Address - Country:US
Mailing Address - Phone:323-943-8477
Mailing Address - Fax:
Practice Address - Street 1:6532 PACIFIC BLVD # C
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4106
Practice Address - Country:US
Practice Address - Phone:323-588-5971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling