Provider Demographics
NPI:1043903883
Name:DALEY, LISA LOHR (AMFT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:LOHR
Last Name:DALEY
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 DREXEL DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-2146
Mailing Address - Country:US
Mailing Address - Phone:919-607-3474
Mailing Address - Fax:
Practice Address - Street 1:530 E MONTECITO ST STE 101
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-3245
Practice Address - Country:US
Practice Address - Phone:805-963-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95228531163WG0000X
CA122769106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice