Provider Demographics
NPI:1336972298
Name:LINDBORG, NATHANIEL STEE (LMFT)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:STEE
Last Name:LINDBORG
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7817 HERSCHEL AVE # 101-102
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4454
Mailing Address - Country:US
Mailing Address - Phone:858-295-1815
Mailing Address - Fax:
Practice Address - Street 1:7817 HERSCHEL AVE # 101-102
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4454
Practice Address - Country:US
Practice Address - Phone:858-295-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-24
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147175106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist