Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY 21832 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 21832 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 21832 | CA |
N | 103TF0000X | Family Psychologist | 21832 | CA |
NPI | 1013081504 |
---|---|
Provider Name | Dr. Lisa Jo Cohen |
First Address | Westlake Village, CA 91361-2810 |
Second Address | Westlake Village, CA 91361-2810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 23/06/2017 |