Basic Information
| Provider Information | |||||||||
| NPI: | 1154510972 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHAU | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | L.C.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7329 E SKYLINE DR | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928676451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146148853 | ||||||||
| FaxNumber: | 7144948117 | ||||||||
| Practice Location | |||||||||
| Address1: | 2035 E BALL RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928065157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145176300 | ||||||||
| FaxNumber: | 7145176306 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2007 | ||||||||
| LastUpdateDate: | 06/08/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | ASW14375 | CA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | LCS 24765 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.