MR. Ross Lisman JR., PHD

NPI #1104375419 in San Dimas, California

Provider Information

NPI Number: 1104375419
Entity Type: Individual
Name: MR. Ross Lisman JR., PHD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Clinical
Credential: PHD
Enumeration Date: Sep 27, 2016
Last Updated: Dec 21, 2022

Practice Location

Address: 304 BEECHWOOD LN
City: San Dimas
State: California
ZIP Code: 91773-3605
Phone: (614) 205-8454

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Psychologist - Clinical — Clinical	103TC0700X	Primary

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