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Contact Information

LISA S LY
5500 UNIVERSITY PARKWAY
SAN BERNARDINO, CA92407
 Phone: 909-537-5495
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for LISA S LY · (Female)

NPI # 1225727845
Status Active
Credentials
Entity Individual
Enumeration date 05/01/2023
Last updated 05/01/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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