Provider Demographics
NPI:1134453764
Name:TALLEY, LISA ELLEN (DONA CD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ELLEN
Last Name:TALLEY
Suffix:
Gender:F
Credentials:DONA CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7994 VIA HOJA
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-9016
Mailing Address - Country:US
Mailing Address - Phone:760-331-8016
Mailing Address - Fax:
Practice Address - Street 1:7994 VIA HOJA
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-9016
Practice Address - Country:US
Practice Address - Phone:760-331-8016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula