Provider Demographics
NPI:1922178649
Name:DEEBLE, LISA (PSY D)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:DEEBLE
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 E WALTON ST
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-2728
Mailing Address - Country:US
Mailing Address - Phone:562-290-0456
Mailing Address - Fax:
Practice Address - Street 1:707 E WALTON ST
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-2728
Practice Address - Country:US
Practice Address - Phone:562-290-0456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health