DR. LISA BLACK (NPI# 1609302678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609302678 |
| Entity Type | Individual |
| Full Name | DR. LISA BLACK |
| Credential | PSYD |
| Practice Address |
200 W Arbor Dr San Diego CA 92103-9000 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 6194719260 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2019-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY29110 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326396706 | Lisa Marie Black | Physical Therapy Assistant | 3433 Cranston Cir, Highlands Ranch, CO 80126-3620 | 2012-08-16 |
| 1780944520 | Lisa Anne Black | Nurse Practitioner | 220 S Courtenay Pkwy, Suite B, Merritt Island, FL 32952-4893 | 2012-05-28 |
| 1659631240 | Lisa Black | Physical Therapist | 11524 Spaulding St, Omaha, NE 68164-2366 | 2012-05-17 |
| 1497086219 | Lisa Lynn Black | Midwife | 3917 Hickory Bend Trl, Mckinney, TX 75071-2776 | 2010-01-18 |
| 1871780387 | Lisa Gail Black | Massage Therapist | 525 13th Avenue, Huntington, WV 25701 | 2007-09-28 |
| 1386787661 | Lisa Myers Black | Psychologist | 4003 24th Ave Ne, Norman, OK 73071-7749 | 2007-02-15 |
| 1851484307 | Lisa Breaux Black | Family Medicine | 895 Verret St, Houma, LA 70360-4635 | 2006-10-02 |
| 1730152653 | Lisa B Black | Internal Medicine | 701 E Marshall St Ste 640, West Chester, PA 19380-4412 | 2006-02-10 |
| 1922607696 | Lisa Black | Home Health Aide | 1119 S New York Ave, Wellston, OH 45692-2427 | 2020-10-22 |
| 1720582398 | Lisa Black | Occupational Therapist | 7445 Allen Rd Ste 102, Allen Park, MI 48101-1992 | 2018-03-20 |
| Street Address |
200 W ARBOR DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215502 | Alfredo B. Tiu | Internal Medicine | 200 W Arbor Dr, Owen Clinic, San Diego, CA 92103-9001 | 2005-06-20 |
| 1841806536 | Kevin Thai Nguyen | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-18 |
| 1003421256 | Jessica Lynette Montoya | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-14 |
| 1013522838 | Julianna L Gorder | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-09 |
| 1992318828 | Yodit Mekonnen Teklu | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1356954283 | Dalia Siada | Dietitian, Registered | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1699383588 | Rachael Ashley Gordon | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-17 |
| 1124646906 | Jeffrey David Bernstein | Student in an Organized Health Care Education/Training Program | 200 W Arbor Dr, Mc 1234, San Diego, CA 92103-9000 | 2020-07-08 |
| 1639796071 | Darcie D Brown | Marriage & Family Therapist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-01 |
| 1194340919 | Han B Dinh | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184231730 | Joanna Lesley Kaye | Psychologist | 3555 Rosecrans St Ste 114-212, San Diego, CA 92110-3231 | 2020-09-28 |
| 1396353520 | Chandra Estelle Khalifian | Psychologist | 4975 Foothill Blvd, San Diego, CA 92109-2236 | 2020-07-14 |
| 1225661838 | Sharon Saeedi Psy D Psychologist Inc | Psychologist | 185 W F St Ste 100l, San Diego, CA 92101-6029 | 2020-02-21 |
| 1609414242 | Laura Beth Fitzpatrick | Psychologist | 3322 29th St, San Diego, CA 92104-4533 | 2019-12-13 |
| 1790329613 | Growgood Psychology, Corp | Psychologist | 3405 Kenyon St # 513-06, San Diego, CA 92110-5003 | 2019-11-04 |
| 1891355996 | Stephanie Ann Massey | Psychologist | 12625 High Bluff Dr Ste 206, San Diego, CA 92130-2053 | 2019-06-19 |
| 1225697543 | Dr. Emily N. Kierce, Psychologist, A Professional Corporation | Psychologist | 402 W Broadway Ste 1925, San Diego, CA 92101-8505 | 2019-06-10 |
| 1023674884 | Desiree Arlene Cuevas | Psychologist | 2525 Camino Del Rio S Ste 305, San Diego, CA 92108-3784 | 2019-05-16 |
| 1396212023 | Paul William Randolph | Psychologist | 727 Robinson Ave Apt D, San Diego, CA 92103-4364 | 2018-10-31 |
| 1952876526 | Amanda Cooney | Psychologist | 2515 Old Quarry Rd Apt 1314, San Diego, CA 92108-2759 | 2018-10-09 |
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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.