Individual
LISA BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1991 VILLAGE PARK WAY, 202B, ENCINITAS, CA 92024
(760) 943-1226
(760) 634-7961
Mailing address
1991 VILLAGE PARK WAY, 202B, ENCINITAS, CA 92024
(760) 943-1226
(760) 634-7961
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY15155
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPL151550
BCBS
CA
Enumeration date
09/20/2006
Last updated
07/08/2007
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