Provider Demographics
NPI:1649805821
Name:NEUMANN, LISA (BHP, CADC-II)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:NEUMANN
Suffix:
Gender:F
Credentials:BHP, CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33152 PASEO PINTO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-4621
Mailing Address - Country:US
Mailing Address - Phone:949-838-7905
Mailing Address - Fax:
Practice Address - Street 1:32301 CAMINO CAPISTRANO STE J
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-4512
Practice Address - Country:US
Practice Address - Phone:949-220-2373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-07
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA61308OtherCPC
CAA048601217OtherCADC-II
OH01011528TOtherBHP
CA11-11-T-621-2011-P12OtherTHETAHEALING PRACTITIONER