Individual
MS. LISA VANESSA ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
330 E LIVE OAK AVE, ARCADIA, CA 91006-5617
(626) 821-5858
Mailing address
330 E LIVE OAK AVE, ARCADIA, CA 91006-5617
(626) 821-5858
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT26997
CA
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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