Provider Demographics
NPI:1356669287
Name:TRETTIN, LINDA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:J
Last Name:TRETTIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9580 OAK AVENUE PKWY STE 7
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-9997
Mailing Address - Country:US
Mailing Address - Phone:916-399-3961
Mailing Address - Fax:833-968-1890
Practice Address - Street 1:9580 OAK AVENUE PKWY STE 7
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-9997
Practice Address - Country:US
Practice Address - Phone:916-399-3961
Practice Address - Fax:833-968-1890
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23452103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical