La Tisha Lynn San Pedro-Lintag, LMFT 133780
Individual provider Active NPI Marriage & Family Therapist · Pollock Pines, CA
NPI 1487149407 · NPPES record last updated Aug 26, 2026
Key facts
- NPI
- 1487149407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 133780 (CA)
- Practice address
- 3431 Sly Park Rd
Pollock Pines, CA 95726-9520 - Phone
- (209) 975-7919
- NPI assigned
- Jun 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240402002299 | CA | Practitioner - Marriage and Family Therapist | 4789022302 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrative Marriage Family and Individual Therapy, Incorporated | Marriage & Family Therapist | Current |
Accepting new patients |
| Cyti Health PC | Current |
Accepting new patients | |
| Grow Healthcare Group PC | Mental Health | Current |
Accepting new patients |
| Life Practice Counseling Group | Past | Accepting new patients |
Locations
520 Plaza Dr
Ste 140
Folsom, CA 95630
Phone (916) 307-5506
11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317
402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939
3111 Camino del Rio N
Ste 460
San Diego, CA 92108
99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 133780 | CA | Yes |
Addresses
Primary practice location
3431 Sly Park Rd
Pollock Pines, CA 95726-9520
Mailing address
PO Box 445
Pollock Pines, CA 95726-0445
Phone (916) 583-4426
Other practice location 1
507 Natoma St
Folsom, CA 95630-2523
Phone (916) 583-4426
Other providers in Pollock Pines, CA
- Lindsey Rogers
- Theresa Joanne Russell
- Safeway Inc
- Sapna Sahota
- Debbie Salvino
- Shining Star Children'S Therapy, Inc
- Sierra Pines Speech Therapy & Myofunctional Services
- Jessica Spangler
- Robert John Stadelhofer
- Marbel D Steves
All providers in Pollock Pines, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.