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General NPI Number Information
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NPI Number | 1689148546
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Entity Type | Individual
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Provider Name | MS. LISA DEAN
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Gender | Female
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 151 S DOHENY DR STE 8
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2509
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Country | US
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Telephone | 424-313-2932
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Fax |
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Provider Business Mailing Address
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Address Line | 11901 SANTA MONICA BLVD STE 654
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City | LOS ANGELES
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State | CA
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Zip | 90025-5190
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Country | US
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Telephone | 424-313-2932
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 4531
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License Number State | CA
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