Provider Demographics
NPI:1922454263
Name:AGUIRRE, LYSANDRA PASCHER
Entity Type:Individual
Prefix:
First Name:LYSANDRA
Middle Name:PASCHER
Last Name:AGUIRRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYSANDRA
Other - Middle Name:
Other - Last Name:PASCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:22431 DARDENNE ST
Mailing Address - Street 2:NONE
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5821
Mailing Address - Country:US
Mailing Address - Phone:818-795-2554
Mailing Address - Fax:
Practice Address - Street 1:22431 DARDENNE ST
Practice Address - Street 2:NONE
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5821
Practice Address - Country:US
Practice Address - Phone:818-795-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS204331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical