Lisa Marie Slosarik, PHD
Individual provider Active NPI Forensic Psychologist · Avenal, CA
NPI 1104177013 · NPPES record last updated Oct 2, 2012
Key facts
- NPI
- 1104177013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Forensic Psychologist 103TF0200X
- License
- PSY23551 (CA)
- Practice address
- 1 Kings Way
Avenal, CA 93204-9708 - Phone
- (559) 386-0587
- NPI assigned
- Oct 2, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY23551 | CA | MD | Forensic Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | PSY23551 | CA | Yes |
Addresses
Primary practice location
1 Kings Way
Avenal, CA 93204-9708
Mailing address
9882 N Price Ave
Fresno, CA 93720-4687
Phone (559) 434-2344
Other providers in Avenal, CA
- Dean Robinson
- Veronica Macias Rodriguez
- Mellissa Stephanie Ruiz-Lott
- Jeffer Y Sabino
- Mark Masami Sakai
- Tyler Jensen Smith
- Camille Ross Summons
- Ratana Tak
- Christal L Torres
- Dao Bic Tran
All providers in Avenal, CA · Forensic Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.