Provider Demographics
NPI:1902073398
Name:LAINER, LISA BARNES (PHD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:BARNES
Last Name:LAINER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2566 OVERLAND AVE
Mailing Address - Street 2:SUITE 500B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3366
Mailing Address - Country:US
Mailing Address - Phone:310-967-5041
Mailing Address - Fax:310-204-5721
Practice Address - Street 1:2566 OVERLAND AVE
Practice Address - Street 2:SUITE 500B
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3366
Practice Address - Country:US
Practice Address - Phone:310-967-5041
Practice Address - Fax:310-204-5721
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14680103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist