Provider Demographics
NPI:1235843582
Name:CHESTER-SCHYMAN, LISA RACHEL
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:RACHEL
Last Name:CHESTER-SCHYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4842 SALEM VILLAGE PL
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4324
Mailing Address - Country:US
Mailing Address - Phone:310-528-9082
Mailing Address - Fax:
Practice Address - Street 1:4842 SALEM VILLAGE PL
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4324
Practice Address - Country:US
Practice Address - Phone:310-528-9082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA136293106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist