Provider Demographics
NPI:1558748830
Name:MURILLO, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:MURILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARIE
Other - Last Name:SCHLEHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6957 N FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-1245
Mailing Address - Country:US
Mailing Address - Phone:323-855-0558
Mailing Address - Fax:323-443-3267
Practice Address - Street 1:6957 N FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-1245
Practice Address - Country:US
Practice Address - Phone:323-855-0558
Practice Address - Fax:323-443-3267
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA691991163WC0400X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management