Individual
LISA RENEE CASEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
151 KALMUS DR STE K3, COSTA MESA, CA 92626-5975
(714) 384-3870
Mailing address
151 KALMUS DR STE K3, COSTA MESA, CA 92626-5975
(714) 384-3870
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
395198
CA
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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