LISA SULLIVAN (NPI# 1215247804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215247804 |
| Entity Type | Individual |
| Full Name | LISA SULLIVAN |
| Credential | M.A. LMFT |
| Practice Address |
913 Willow St Ste 103 San Jose CA 95125-2380 |
| Practice Telephone | 4084409047 |
| Mailing Telephone | 4084409047 |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2010-10-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 38725 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285282459 | Lisa Sullivan | Behavior Technician | 719 N Hillview Dr, Boise, ID 83712-8122 | 2019-08-29 |
| 1184183550 | Lisa Sullivan | Contractor | 113 Constitution Ct Apt A, Albany, GA 31721-2150 | 2019-03-15 |
| 1366875197 | Lisa Sullivan | Counselor | 3740 Colony Dr Ste 260, San Antonio, TX 78230-2233 | 2013-08-15 |
| 1336486414 | Lisa Marie Sullivan | Social Worker | 18 Rose Pl, Selden, NY 11784-3122 | 2013-01-10 |
| 1144579418 | Lisa Sullivan | Specialist | 252 California Ct, Mission Viejo, CA 92692-4098 | 2012-09-02 |
| 1811205750 | Lisa Renee Sullivan | Physician Assistant | 44305 Harmony Ln, Belleville, MI 48111-2449 | 2010-09-14 |
| 1700014065 | Lisa Hadeler Sullivan | Physical Therapist | 1420 Hwy 36, Hazlet, NJ 07730-1736 | 2009-06-25 |
| 1083874127 | Lisa Meghan Sullivan | Massage Therapist | 1640 Selby Ave Apt 6, Saint Paul, MN 55104-7379 | 2008-06-12 |
| 1841380375 | Lisa C. Sullivan | Pediatrics | 4950 Se Roethe Rd, Milwaukie, OR 97267-5746 | 2006-10-13 |
| 1386650273 | Lisa Marie Sullivan | Allergy & Immunology | 737 Saint Johns Ave, Highland Park, IL 60035-4650 | 2006-07-31 |
| Street Address |
913 WILLOW ST STE 103 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95125-2380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881821791 | Suzanna Lynn Freerksen | Psychiatry & Neurology | 913 Willow St Ste 103, San Jose, CA 95125-2380 | 2009-06-18 |
| 1619449105 | Suzanna Freerksen, Md, Inc. | Psychiatry & Neurology | 913 Willow St Ste 103, San Jose, CA 95125-2380 | 2018-12-20 |
| 1114454121 | Mark Mouro | Marriage & Family Therapist | 913 Willow St Ste 103, San Jose, CA 95125-2380 | 2017-05-22 |
| 1821476235 | Kimberly Black | Marriage & Family Therapist | 913 Willow St Ste 103, San Jose, CA 95125-2380 | 2015-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245431 | Carmen J. Frank | Marriage & Family Therapist | 913 Willow St., Suite 103, San Jose, CA 95125 | 2020-08-12 |
| 1376197848 | Mariam Samir Abadir | Dentist | 1670 Westwood Dr. Suite K, San Jose, CA 95125 | 2019-08-01 |
| 1750870747 | Gertrud Stojancic | Massage Therapist | 3315 Almaden Expressway, # 27/29, San Jose, CA 95125 | 2018-05-04 |
| 1659809259 | Edward Escoto | Assistant Behavior Analyst | 2075 Lincoln Ave Ste D, San Jose, CA 95125 | 2017-05-25 |
| 1104288422 | Kristin Ann Dessau | Counselor | 1261 Lincoln Avenue, Suite 202, San Jose, CA 95125 | 2016-03-25 |
| 1275964488 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1685 Westwood Dr Ste 1, San Jose, CA 95125 | 2013-12-13 |
| 1598042905 | Walgreens | Exclusive Provider Organization | 2585 Almaden Road, San Jose, CA 95125 | 2011-11-14 |
| 1881981488 | Kevin Jia-chian Yen | Dentist | 1660 Willow St Ste 5, San Jose, CA 95125 | 2011-07-02 |
| 1699093724 | Lokahi Acupuncture, Inc. | Acupuncturist | 1688 Willow Street, Suite B, San Jose, CA 95125 | 2010-05-13 |
| 1538482468 | Mark Lucius Yoslow | Psychologist | 970 Minnesota Avenue, San Jose, CA 95125 | 2010-03-06 |
| Find all providers in zip 95125 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372377 | Ratzburg Family Counseling Corporation | Marriage & Family Therapist | 465 Chinook Ln, San Jose, CA 95123-3311 | 2020-09-25 |
| 1285245431 | Carmen J. Frank | Marriage & Family Therapist | 913 Willow St., Suite 103, San Jose, CA 95125 | 2020-08-12 |
| 1083230981 | Joanna Leigh Carson-young | Marriage & Family Therapist | 1769 Park Ave Ste 220, San Jose, CA 95126-2025 | 2020-06-17 |
| 1144857467 | Glenn M Tanimura | Marriage & Family Therapist | 1079 Noble Ln, San Jose, CA 95132-3128 | 2020-03-25 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1992339196 | Brenda Ann Farrell | Marriage & Family Therapist | 1625 The Alameda Ste 711, San Jose, CA 95126-2225 | 2020-02-26 |
| 1619507472 | Michelle Marie Wambach | Marriage & Family Therapist | 4020 Moorpark Ave Ste 206, San Jose, CA 95117-1846 | 2020-01-21 |
| 1699313080 | Juan Carlos Mercado | Marriage & Family Therapist | 290 North 2nd St, San Jose, CA 95112 | 2019-12-16 |
| 1497398002 | Veronica Marie Ayala | Marriage & Family Therapist | 840 Guadalupe Pkwy Fl 2, San Jose, CA 95110-1714 | 2019-10-26 |
| 1700428224 | Lynn Huggins | Marriage & Family Therapist | 1625 The Alameda Ste 304, San Jose, CA 95126-2223 | 2019-10-16 |
| Find all providers in SAN JOSE | ||||
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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.