Pink, Lisa Marie

Pink, Lisa Marie is an sole proprietor health care provider with primary practice located at 18612 Santa Ana Ave , Bloomington CA 92316-2639. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Pink, Lisa Marie can be contacted via phone (909) 421-7120.

Contact Information

Primary practice address
18612 Santa Ana Ave Bloomington CA 92316-2639
Phone: (909) 421-7120
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1386988137
LBN Legal business name Pink, Lisa Marie
Credentials CADC-I
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 18th, 2012
Last updated Jan 4th, 2022 - about 2 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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