| Doctor Name: | DR. LISA ELAINE WOLF |
| NPI Number: | 1033313531 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | PSY 16388 |
| Business Practice Address: | 15910 Ventura Blvd Suite 1017 Encino, CA - 914362802 |
| Business Phone Number: | 8183866700 |
| Business Fax Number: | 8183866744 |
| Mailing Address: | 16951 W Sunset Blvd, PACIFIC PALISADES |
| State: | CA |
| Postal Code: | 902723208 |
| Phone Number: | 3105699792 |
| Fax Number: | 3104595926 |
| NPI Enumeration Date: | 06/11/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 16388 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |