DR. LISA LAVAYSSE (NPI# 1144549916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144549916 |
Entity Type | Individual |
Full Name | DR. LISA LAVAYSSE |
Credential | PSY.D. |
Practice Address |
205 E 3rd Ave Mezzanine 1-a San Mateo CA 94401-4051 |
Practice Telephone | 6505763017 |
Mailing Telephone | 6505763017 |
Enumeration Date | 2010-05-19 |
Last Update Date | 2010-05-19 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 103TC0700X |
Psychologist Specialization: Clinical |
PSY20002 | CA | Behavioral Health & Social Service Providers |
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY20002 | CA | Behavioral Health & Social Service Providers |
Street Address |
205 E 3RD AVE MEZZANINE 1-A |
City | SAN MATEO |
State | CA |
Zip Code | 94401-4051 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760592901 | Krysta A Banazek | Marriage & Family Therapist | 205 E 3rd Ave, Suite 207a, San Mateo, CA 94401-4051 | 2006-08-30 |
1609266402 | Michelle Busch Potter | Marriage & Family Therapist | 205 E 3rd Ave, Suite 307c, San Mateo, CA 94401-4051 | 2015-01-31 |
1982954061 | Kimberly Dawn Rich | Marriage & Family Therapist | 205 E 3rd Ave, Suite 303, San Mateo, CA 94401-4051 | 2012-09-14 |
1942567615 | Spring Tide Natural Health | Acupuncturist | 205 E 3rd Ave, Suite 206, San Mateo, CA 94401-4051 | 2012-04-18 |
1013150176 | Eva K Pang | Psychologist | 205 E 3rd Ave, San Mateo, CA 94401-4051 | 2009-04-19 |
1427290576 | Mark Sapaen Watan | Acupuncturist | 205 E 3rd Ave, Suite 410, San Mateo, CA 94401-4051 | 2009-04-02 |
1295982254 | Terri Lyn Zucker | Psychologist | 205 E 3rd Ave, Ste 208, San Mateo, CA 94401-4051 | 2008-08-21 |
1609041185 | Richard Stewart Cameron | Counselor | 205 E 3rd Ave, Suite 203, San Mateo, CA 94401-4051 | 2008-04-25 |
1629279757 | Marilyn Mellott Bacigalupi | Marriage & Family Therapist | 205 E 3rd Ave, 315, San Mateo, CA 94401-4051 | 2007-05-29 |
1396957353 | Joan C Haller | Social Worker | 205 E 3rd Ave, San Mateo, CA 94401-4051 | 2007-05-04 |
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1841800760 | Monica Marie Rivas | Behavior Technician | 429 Peninsula Avenue, San Mateo, CA 94401 | 2020-08-05 |
1609412865 | Cindy Toshiko Hedlin | Marriage & Family Therapist | 1117 S. B Street, Suite 9, San Mateo, CA 94401 | 2019-11-22 |
1750846655 | James Court Manor Inc. | Assisted Living Facility | 1316 James Court, San Mateo, CA 94401 | 2019-02-05 |
1467991778 | Maria Elena Lopez | Student in an Organized Health Care Education/Training Program | 325 Villa Terrace, San Mateo, CA 94401 | 2017-02-20 |
1487198339 | Johnie Pangelina | Behavioral Analyst | 242 Peninsula Ave, San Mateo, CA 94401 | 2016-12-12 |
1740736230 | Meredith Eileen Morgan | Dentist | 100 S. Ellsworth Av, #601, San Mateo, CA 94401 | 2016-08-25 |
1376998963 | Lior Tamir | Dentist | 800 B Street Suite #200, San Mateo, CA 94401 | 2016-05-02 |
1609233584 | Delicia Ortega | Behavioral Analyst | 424 Peninsula Avenue, San Mateo, CA 94401 | 2016-01-22 |
1396122388 | Ramy Salah | Internal Medicine | 50 S San Mateo Dr Ste 480, San Mateo, CA 94401 | 2015-04-29 |
1508255902 | Risso Counseling, Inc. | Marriage & Family Therapist | 120 North El Camino Real, San Mateo, CA 94401 | 2015-01-22 |
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Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.