Provider Demographics
NPI:1861680167
Name:JETER, LINDA LANDELE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LANDELE
Last Name:JETER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:LANDELE
Other - Last Name:JETER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:10717 CAMINO RUIZ STE 207
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2364
Mailing Address - Country:US
Mailing Address - Phone:858-695-2211
Mailing Address - Fax:858-695-3521
Practice Address - Street 1:4975 WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-7408
Practice Address - Country:US
Practice Address - Phone:951-837-3439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105090106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist