Provider Demographics
NPI:1760058465
Name:RITTER-INGORVAIA, LINDSEY JEAN
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JEAN
Last Name:RITTER-INGORVAIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31805 TEMECULA PKWY # D7-308
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-8203
Mailing Address - Country:US
Mailing Address - Phone:858-519-9940
Mailing Address - Fax:
Practice Address - Street 1:31805 TEMECULA PKWY # D7-308
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-8203
Practice Address - Country:US
Practice Address - Phone:855-519-1994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 171M00000X, 172V00000X
CALPCC16621101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty