Odom, Lisa Nichole

Odom, Lisa Nichole is an individual health care provider with primary practice located at 2120 Alpine Blvd. 2120 Alpine Boulevard, Alpine CA 91901. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Odom, Lisa Nichole can be contacted via phone (619) 544-0633.

Contact Information

Primary practice address
2120 Alpine Blvd. 2120 Alpine Boulevard Alpine CA 91901
Phone: (619) 544-0633
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1801108345
LBN Legal business name Odom, Lisa Nichole
Credentials PSY.D
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2010
Last updated Feb 10th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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