Provider Demographics
NPI:1679897342
Name:DINGLASAN, LISA (MSW, MPA, LCSW, ACM)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:DINGLASAN
Suffix:
Gender:F
Credentials:MSW, MPA, LCSW, ACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 UNIVERSITY DR # 511
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2965
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 E KATELLA AVE STE 800
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-5955
Practice Address - Country:US
Practice Address - Phone:949-232-0860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA775441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical