Basic Information
| Provider Information | |||||||||
| NPI: | 1598906851 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSTERMAN | ||||||||
| FirstName: | LISA | ||||||||
| MiddleName: | DAWN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MFTI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10929 SOUTH ST STE 208B | ||||||||
| Address2: | |||||||||
| City: | CERRITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907035368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629245526 | ||||||||
| FaxNumber: | 5629241040 | ||||||||
| Practice Location | |||||||||
| Address1: | 10929 SOUTH ST STE 208B | ||||||||
| Address2: | |||||||||
| City: | CERRITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907035368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629245526 | ||||||||
| FaxNumber: | 5629241040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2009 | ||||||||
| LastUpdateDate: | 03/17/2009 | ||||||||
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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 | 101YM0800X | MFTI 57959 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.