Provider Demographics
NPI:1043369085
Name:TWILLING, LISA LOUISE (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:LOUISE
Last Name:TWILLING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3667 SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1709
Mailing Address - Country:US
Mailing Address - Phone:415-721-4708
Mailing Address - Fax:415-380-8275
Practice Address - Street 1:3667 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1709
Practice Address - Country:US
Practice Address - Phone:415-721-4708
Practice Address - Fax:415-380-8275
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16468103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical