Provider Demographics
NPI:1669793741
Name:BAHAR, LISA CHRISTINE (LMFT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:CHRISTINE
Last Name:BAHAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MONARCH BAY PLZ
Mailing Address - Street 2:SUITE 249
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3424
Mailing Address - Country:US
Mailing Address - Phone:949-248-4657
Mailing Address - Fax:949-493-9350
Practice Address - Street 1:28 MONARCH BAY PLZ
Practice Address - Street 2:N
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3460
Practice Address - Country:US
Practice Address - Phone:949-248-4657
Practice Address - Fax:949-493-9350
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-12
Last Update Date:2010-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47796106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist