Provider Demographics
NPI:1881784981
Name:RICHTER, LISA J (MFT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:RICHTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7803 MADISON AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7600
Mailing Address - Country:US
Mailing Address - Phone:916-658-9983
Mailing Address - Fax:916-863-6074
Practice Address - Street 1:6609 FOLSOM AUBURN RD STE 100
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2101
Practice Address - Country:US
Practice Address - Phone:916-261-1586
Practice Address - Fax:916-863-6074
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 33007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health