Individual
MS. LISA LYNETTE HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
52 DORE ST, SAN FRANCISCO, CA 94103-3828
(415) 553-3100
(415) 861-0257
Mailing address
368 FELL ST, SAN FRANCISCO, CA 94102-5144
(415) 861-0828
(415) 861-0257
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT26009
CA
Other
Enumeration date
04/21/2011
Last updated
04/21/2011
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