Healthcare Provider Details

I. General information

NPI: 1619161106
Provider Name (Legal Business Name): ALISA HOPE LITE PSY. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11401 BLOOMFIELD AVE
NORWALK CA
90650-2015
US

IV. Provider business mailing address

11401 BLOOMFIELD AVE
NORWALK CA
90650-2015
US

V. Phone/Fax

Practice location:
  • Phone: 562-863-7011
  • Fax: 562-864-4560
Mailing address:
  • Phone: 562-651-2228
  • Fax: 916-654-3186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY21194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: