Provider Demographics
NPI:1801168182
Name:SALDANA, R. LISA (PHD, QMHP)
Entity type:Individual
Prefix:
First Name:R. LISA
Middle Name:
Last Name:SALDANA
Suffix:
Gender:F
Credentials:PHD, QMHP
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:SALDANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, QMHP
Mailing Address - Street 1:10 SHELTON MCMURPHEY BLVD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4928
Mailing Address - Country:US
Mailing Address - Phone:541-485-2711
Mailing Address - Fax:888-975-0250
Practice Address - Street 1:1255 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3570
Practice Address - Country:US
Practice Address - Phone:541-799-5386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500663572Medicaid
OR500720431Medicaid