Provider Demographics
NPI:1457502650
Name:ALBERT, LISA (LCSW, PPSC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:LCSW, PPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N BROOKHURST ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-5226
Mailing Address - Country:US
Mailing Address - Phone:714-490-7711
Mailing Address - Fax:714-490-7717
Practice Address - Street 1:501 N BROOKHURST ST
Practice Address - Street 2:SUITE 320
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5226
Practice Address - Country:US
Practice Address - Phone:714-490-7711
Practice Address - Fax:714-490-7717
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 185641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7565AOtherOUTPATIENT MENTAL HEALTH