Provider Demographics
NPI:1265231310
Name:EURICH KIBBE, LISA (CHT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:EURICH KIBBE
Suffix:
Gender:
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21221 OXNARD ST.
Mailing Address - Street 2:STE. 648
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367
Mailing Address - Country:US
Mailing Address - Phone:818-822-7622
Mailing Address - Fax:
Practice Address - Street 1:21221 OXNARD ST.
Practice Address - Street 2:STE. 648
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367
Practice Address - Country:US
Practice Address - Phone:818-822-7622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1421820321101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)