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General NPI Number Information
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NPI Number | 1962630350
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Entity Type | Individual
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Provider Name | PATRICIA L. YAMAMOTO LISAC
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Gender | Female
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 13820 NORTH 51ST AVE 100
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City | GLENDALE
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State | AZ
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Zip | 85306-9306
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Country | US
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Telephone | 623-398-8904
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Fax | 623-414-3448
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Provider Business Mailing Address
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Address Line | 13820 NORTH 51ST AVE 100
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City | GLENDALE
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State | AZ
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Zip | 85306-9306
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Country | US
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Telephone | 623-398-8904
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Fax | 623-414-3448
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LISAC-11893
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License Number State | AZ
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