Basic Information
| Provider Information | |||||||||
| NPI: | 1538255245 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAZLEWOOD-HUNT | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 920 AVE. DE SAN CLEMENTE | ||||||||
| Address2: | |||||||||
| City: | ENCINITAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7609440065 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11770 BERNARDO PLAZA CT. SUITE 260 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8584879050 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PSY12052 | CA | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.