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General NPI Number Information
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NPI Number | 1861921462
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Entity Type | Individual
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Provider Name | LISA ANTOINETTE TEMPLE LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/07/2017
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 1000 G ST
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City | SACRAMENTO
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State | CA
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Zip | 95814-0840
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Country | US
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Telephone | 888-588-8995
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Fax |
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Provider Business Mailing Address
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Address Line | 16063 S TRUSS DR
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City | BLUFFDALE
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State | UT
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Zip | 84065-1867
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Country | US
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Telephone | 801-979-9404
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 102682
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License Number State | CA
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