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General NPI Number Information
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NPI Number | 1891119640
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Entity Type | Individual
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Provider Name | LISA HIROKO OKUTSU AMARLAPUDI PSYD
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Gender | Female
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 121 W SIERRA ST
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City | KINGSBURG
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State | CA
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Zip | 93631
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Country | US
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Telephone | 559-392-0834
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 737
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City | SAN JOAQUIN
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State | CA
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Zip | 93660-0737
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Country | US
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Telephone | 559-392-0834
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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 | 31356
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License Number State | CA
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