Individual
LISA KOPONEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 MAIN ST, WEAVERVILLE, CA 96093-1099
(530) 623-1362
Mailing address
PO BOX 1640, WEAVERVILLE, CA 96093-1640
(530) 623-1362
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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