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General NPI Number Information
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NPI Number | 1437341997
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Entity Type | Individual
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Provider Name | LISA DIANE RAPALLO LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 11301 WILSHIRE BLVD, BLDG 217 VETERAN'S ADMINISTRATION HOSPITAL (DOMICILIARY)
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City | LOS ANGELES
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State | CA
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Zip | 90049
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Country | US
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Telephone | 310-478-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 400 W BENSON BLVD
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City | ANCHORAGE
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State | AK
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Zip | 99503-3829
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Country | US
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Telephone | 907-231-0536
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 202688
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 28223
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License Number State | CA
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