Healthcare Provider Details

I. General information

NPI: 1750784245
Provider Name (Legal Business Name): LINDSEY NOLENE GRODZICKI LMFT119598
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2014
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 HUNTINGTON POINT RD UNIT 68
CHULA VISTA CA
91914-4500
US

IV. Provider business mailing address

2240 HUNTINGTON POINT RD UNIT 68
CHULA VISTA CA
91914-4500
US

V. Phone/Fax

Practice location:
  • Phone: 619-200-9581
  • Fax:
Mailing address:
  • Phone: 619-200-9581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT119598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: