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General NPI Number Information
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NPI Number | 1982210811
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Entity Type | Individual
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Provider Name | LISA ALLEN AMFT, APCC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 2339 11TH ST
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City | ENCINITAS
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State | CA
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Zip | 92024-6604
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Country | US
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Telephone | 760-456-7462
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Fax |
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Provider Business Mailing Address
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Address Line | 352 DELAWARE ST
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City | IMPERIAL BEACH
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State | CA
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Zip | 91932-1421
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7995
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 120958
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License Number State | CA
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