Provider Demographics
NPI:1447300827
Name:COX, LISA LYNNE (LMFT)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:LYNNE
Last Name:COX
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:FOREST RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:95942-0457
Mailing Address - Country:US
Mailing Address - Phone:530-343-1556
Mailing Address - Fax:530-343-1556
Practice Address - Street 1:107 PARMAC RD STE 4
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2218
Practice Address - Country:US
Practice Address - Phone:530-891-2850
Practice Address - Fax:530-895-6549
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT31988106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist