Provider Demographics
NPI:1942593207
Name:KLIPFEL, LISA C (MA)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:C
Last Name:KLIPFEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 CAMINO CAPISTRANO STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4854
Mailing Address - Country:US
Mailing Address - Phone:949-891-2127
Mailing Address - Fax:
Practice Address - Street 1:2738 CAMINO CAPISTRANO
Practice Address - Street 2:3
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4854
Practice Address - Country:US
Practice Address - Phone:949-891-2127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35517106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist