Sullivan, Lisa Maria

Sullivan, Lisa Maria is an sole proprietor health care provider with primary practice located at 1000 Quail St , Newport Beach CA 92660-2731. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Sullivan, Lisa Maria can be contacted via phone (714) 875-7190.

Contact Information

Primary practice address
1000 Quail St Newport Beach CA 92660-2731
Phone: (714) 875-7190
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MFC 43533 California

Profile Details

NPI number 1558521005
LBN Legal business name Sullivan, Lisa Maria
Credentials Marriage and Family Therapist (MFT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2008
Last updated Jun 9th, 2008 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1558521005 NPPES
California MEDICAID 10

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