Provider Demographics
NPI:1629686555
Name:FLORES, LISABETH
Entity Type:Individual
Prefix:
First Name:LISABETH
Middle Name:
Last Name:FLORES
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 1:1300 MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-1946
Mailing Address - Country:US
Mailing Address - Phone:707-721-3500
Mailing Address - Fax:
Practice Address - Street 1:1300 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-1946
Practice Address - Country:US
Practice Address - Phone:707-721-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health