Provider Demographics
NPI:1518345099
Name:DI MARTINO, LINDSEY
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:DI MARTINO
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:PO BOX 16260
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92176-6260
Mailing Address - Country:US
Mailing Address - Phone:619-401-5500
Mailing Address - Fax:
Practice Address - Street 1:900 N CUYAMACA ST
Practice Address - Street 2:SUITE 110
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1809
Practice Address - Country:US
Practice Address - Phone:619-448-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108564106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist