Provider Demographics
NPI:1225327331
Name:MILLER, LISA HEIDT (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:HEIDT
Last Name:MILLER
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:10992 SAN DIEGO MISSION RD
Mailing Address - Street 2:KAISER HOSPICE THIRD FLOOR
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2444
Mailing Address - Country:US
Mailing Address - Phone:619-641-4483
Mailing Address - Fax:619-641-4111
Practice Address - Street 1:10992 SAN DIEGO MISSION RD
Practice Address - Street 2:KAISER HOSPICE THIRD FLOOR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2444
Practice Address - Country:US
Practice Address - Phone:619-641-4483
Practice Address - Fax:619-641-4111
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA237871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical