Most Relevant Information
Provider Data
| NPI Number: | 1003396151 |
| Provider Name: | LISA CARTER |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/17/2018 |
| Last Updated: | 08/27/2019 |
Provider Practice Location
534 B ST
SANTA ROSA
CA
95401
Practice Location Phone/Fax
| Phone: | 6502710376 |
| Fax: |
Provider Mailing Location
717 MONROE ST
SANTA ROSA
CA
954043929
Provider Mailing Phone/Fax
| Phone: | 6502710376 |
| Fax: |