Provider Demographics
NPI:1538331459
Name:RITTER, LISA P (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:P
Last Name:RITTER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45470 CLUBHOUSE DR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-5963
Mailing Address - Country:US
Mailing Address - Phone:858-449-4141
Mailing Address - Fax:
Practice Address - Street 1:28991 OLD TOWN FRONT ST STE 102
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-2858
Practice Address - Country:US
Practice Address - Phone:951-435-0449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 52355106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist