Healthcare Provider Details

I. General information

NPI: 1689478349
Provider Name (Legal Business Name): LISA HOBSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5297 COLLEGE AVE STE 102
OAKLAND CA
94618-1797
US

IV. Provider business mailing address

5324 MANILA AVE APT 2
OAKLAND CA
94618-1157
US

V. Phone/Fax

Practice location:
  • Phone: 510-916-4062
  • Fax:
Mailing address:
  • Phone: 818-813-4399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number153686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: