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Dr. Lisa Nichole Odom, PSYD
Student in an Organized Health Care Education/Training Program in Alpine, California
NPI 1801108345

Lisa Nichole Odom is a Student in an Organized Health Care Education/Training Program based in Alpine, CA. Lisa Nichole Odom practices in Alpine, CA and has the professional credentials of PSYD. The NPI Number for Lisa Nichole Odom is 1801108345 and holds a License No. (California).

The current practice location address for Lisa Nichole Odom is 2120 Alpine Blvd., Alpine, CA and can be reached out via phone at 619-544-0633.

Location: 2120 Alpine Blvd., Alpine, CA, 91901-2113
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1801108345
Provider Name
Lisa Nichole Odom
Credential
PSYD
Provider Entity Type
Individual
Gender
Female
Address
2120 Alpine Blvd., Alpine, CA, 91901-2113
Phone Number
619-544-0633
Fax Number
Provider Enumeration Date
07/13/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2120 Alpine Blvd.
City
Alpine
State
California
Zip
91901
Phone Number
619-544-0633
Fax Number
person
Provider Business Mailing Address Details
Address
2120 Alpine Blvd.
City
Alpine
State
California
Zip
91901
Phone Number
619-544-0633
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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