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General NPI Number Information
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NPI Number | 1366949943
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Entity Type | Individual
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Provider Name | LISA SLOVER PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 1209 PARK ST STE 301B
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City | PASO ROBLES
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State | CA
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Zip | 93446-7251
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Country | US
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Telephone | 805-791-6040
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Fax |
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Provider Business Mailing Address
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Address Line | 1530 MONTEREY ST STE A
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-2969
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Country | US
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Telephone | 805-791-6040
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY31845
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License Number State | CA
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