Provider Demographics
NPI:1548521669
Name:PIERSON, LISA AKEMI (OTR)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:AKEMI
Last Name:PIERSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4475 DUPONT CT STE 9
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7745
Mailing Address - Country:US
Mailing Address - Phone:805-477-0909
Mailing Address - Fax:805-856-2217
Practice Address - Street 1:4475 DUPONT CT STE 9
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7745
Practice Address - Country:US
Practice Address - Phone:805-477-0909
Practice Address - Fax:805-856-2217
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2840225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist