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Individual

DR. LISA DE LA RUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2350 TURK BLVD, SAN FRANCISCO, CA 94118-4340
(669) 295-5411
Mailing address
2130 FULTON ST, SAN FRANCISCO, CA 94117-1080
(669) 295-5411

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
103T00000X
Psychologist
Primary
35884
CA
103TC1900X
Counseling Psychologist
94026472
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/22/2007
Last updated
05/30/2025
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