Provider Demographics
NPI:1134266893
Name:FINN, LISA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:FINN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ANN
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1414 S MILLER ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-6923
Mailing Address - Country:US
Mailing Address - Phone:805-720-3039
Mailing Address - Fax:805-617-1894
Practice Address - Street 1:1414 S MILLER ST
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-6923
Practice Address - Country:US
Practice Address - Phone:805-720-3039
Practice Address - Fax:805-617-1894
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW22778104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
000009153Medicare UPIN