Provider Demographics
NPI:1629578810
Name:KAISER, LISA LACLAIR (MACP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LACLAIR
Last Name:KAISER
Suffix:
Gender:F
Credentials:MACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6456 RITA RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-8431
Mailing Address - Country:US
Mailing Address - Phone:530-806-3288
Mailing Address - Fax:
Practice Address - Street 1:332 PINE ST STE K
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3312
Practice Address - Country:US
Practice Address - Phone:530-526-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA149308101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health