Healthcare Provider Details

I. General information

NPI: 1679056345
Provider Name (Legal Business Name): LISA LIPTON LMFT PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2018
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 BEETHOVEN ST # A
LOS ANGELES CA
90066-7069
US

IV. Provider business mailing address

2632 WILSHIRE BLVD STE 370
SANTA MONICA CA
90403-4623
US

V. Phone/Fax

Practice location:
  • Phone: 310-462-1361
  • Fax:
Mailing address:
  • Phone: 832-215-5510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT135385
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: