MEDICARE: DR. LISA JERI PERLSON OTD, OTR/L, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	11359	CA
2	106H00000X	Marriage & Family Therapist	52143	CA

General Provider Information

NPI Number	:	1679807861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA JERI PERLSON OTD, OTR/L, LMFT

Provider Business Mailing Address
First Line	:	10137 BRIDLEVALE DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-4611
Country	:	US
Telephone Number	:	310-365-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	10137 BRIDLEVALE DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-4611
Country	:	US
Telephone Number	:	310-365-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2009
Last Update Date	:	03/13/2025

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