Provider Demographics
NPI:1952486953
Name:LINTNER, JEFF (MFT, CEAP)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:LINTNER
Suffix:
Gender:M
Credentials:MFT, CEAP
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 1211
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-6211
Mailing Address - Country:US
Mailing Address - Phone:650-355-2289
Mailing Address - Fax:650-355-1012
Practice Address - Street 1:1301 RALSTON AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-1960
Practice Address - Country:US
Practice Address - Phone:650-615-8141
Practice Address - Fax:650-355-1012
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27326106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist