# INTEGRATIVE MARRIAGE FAMILY AND INDIVIDUAL THERAPY, INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588413538
- **Authorized official:** LA TISHA LYNN SAN PEDRO-LINTAG (DIRECTOR)
- **Authorized official phone:** (916) 583-4426

## Contact information

- **Practice address:** 3431 SLY PARK RD, POLLOCK PINES, CA 95726-9520
- **Practice address phone:** (530) 206-0335
- **Mailing address:** 4231 BALBOA AVE \# 1509, SAN DIEGO, CA 92117-5504
- **Mailing address phone:** (530) 206-0335

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2024
- **Last updated:** 08/26/2026