Provider Demographics
NPI:1548313349
Name:LAMPARSKI, LISA ANN (IMF)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:LAMPARSKI
Suffix:
Gender:F
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 SAPPHIRE ST
Mailing Address - Street 2:# B
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-1434
Mailing Address - Country:US
Mailing Address - Phone:650-295-2160
Mailing Address - Fax:650-286-1325
Practice Address - Street 1:36 37TH AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-4405
Practice Address - Country:US
Practice Address - Phone:650-295-2160
Practice Address - Fax:650-286-1325
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46239106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist