Vine, Lisa

Vine, Lisa is an individual health care provider with primary practice located at 1305 Tommydon St , Stockton CA 95210-3364. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Vine, Lisa can be contacted via phone (209) 476-5490.

Contact Information

Primary practice address
1305 Tommydon St Stockton CA 95210-3364
Phone: (209) 476-5490
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LCS22813 California

Profile Details

NPI number 1891852661
LBN Legal business name Vine, Lisa
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Jan 3rd, 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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