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Contact Information

ROSS LISMAN JR, PHD
304 BEECHWOOD LN
SAN DIMAS, CA91773-3605
 Phone: 614-205-8454
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for ROSS LISMAN JR · (Male)

NPI # 1104375419
Status Active
Credentials PHD
Entity Individual
Enumeration date 09/27/2016
Last updated 12/21/2022 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 32416
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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