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Individual

LISA COLVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
340 CA-HWY 138, CRESTLINE, CA 92325
(909) 336-3330
Mailing address
PO BOX 6300, CRESTLINE, CA 92325-6300

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
373H00000X
Day Training/Habilitation Specialist
Primary

Other

Enumeration date
05/07/2025
Last updated
05/23/2025
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