Individual
DR. LISA JONES
Active
Individual
DR. LISA JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
NE 486
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026721201
—
NE
01
—
11657272
CAQH PROVIDER ID
NE
01
—
NA3283003
MEDICARE PTAN
NE
01
—
P02109644
RR MEDICARE PTAN
NE
Enumeration date
12/29/2005
Last updated
11/11/2021
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