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General NPI Number Information
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NPI Number | 1164229159
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Entity Type | Individual
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Provider Name | LISA MARIE HALSEY RCP, CRT
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Gender | Female
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 11201 BENTON ST
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City | LOMA LINDA
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State | CA
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Zip | 92357-1000
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Country | US
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Telephone | 909-583-6298
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Fax | 909-777-3203
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Provider Business Mailing Address
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Address Line | 11201 BENTON ST
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City | LOMA LINDA
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State | CA
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Zip | 92357-1000
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Country | US
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Telephone | 909-583-6298
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Fax | 909-777-3203
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 20966
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2278P1004X
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Taxonomy Name | Pulmonary Diagnostics Certified Respiratory Therapist
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License Number | 20966
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License Number State | CA
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