Provider Demographics
NPI:1689893232
Name:RIGGS, LISA L
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:L
Last Name:RIGGS
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 1:101 S KRAEMER BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-6105
Mailing Address - Country:US
Mailing Address - Phone:714-577-0400
Mailing Address - Fax:714-577-0408
Practice Address - Street 1:101 S KRAEMER BLVD
Practice Address - Street 2:STE 110
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6105
Practice Address - Country:US
Practice Address - Phone:714-577-0400
Practice Address - Fax:714-577-0408
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16658103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical