Individual provider Active NPI

Litsa Renee Tanner, MS, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1437204716
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC44119 Issued in CA
Practice address
3436 Mendocino Ave Ste C
Santa Rosa, CA 95403-2180
Phone
(707) 545-4600
NPI assigned
Jan 24, 2007
Last updated
Oct 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC44119 CA Primary

Addresses

Primary practice location

3436 Mendocino Ave Ste C
Santa Rosa, CA 95403-2180

Mailing address

3436 Mendocino Ave Ste C
Santa Rosa, CA 95403-2180
Phone (707) 545-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 5, 2024 through Feb 5, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MFC44119CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Adult & Child Center for Cognitive Behavioral Therapy Marriage & Family Therapist CurrentSince Jul 1, 2026 Accepting new patients

Locations

319 S E St
Ste B
Santa Rosa, CA 95404
Phone (707) 694-8316

3436 Mendocino Ave
Ste C
Santa Rosa, CA 95403
Phone (707) 545-4600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791158400000",
    "number": "1437204716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 MENDOCINO AVE STE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032180",
            "telephone_number": "707-545-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 MENDOCINO AVE STE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032180",
            "telephone_number": "707-545-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "LITSA",
        "middle_name": "RENEE",
        "credential": "MS, MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC44119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.