Healthcare Provider Details

I. General information

NPI: 1134357270
Provider Name (Legal Business Name): LISA LOTTATORE-FRENCH PSYD., BCBA-D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2009
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23040 SLEEPING OAK DR
YORBA LINDA CA
92887-3912
US

IV. Provider business mailing address

23040 SLEEPING OAK DR
YORBA LINDA CA
92887-3912
US

V. Phone/Fax

Practice location:
  • Phone: 858-337-9818
  • Fax:
Mailing address:
  • Phone: 858-337-9818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 25812
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY25812
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA-D #1-11-9274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: