| Doctor Name: | LISA SIAVELIS |
| NPI Number: | 1508226994 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CATC III |
| License Number: | 167400 |
| Business Practice Address: | 433 Pyramid Drive Lake Arrowhead, CA - 92325 |
| Business Phone Number: | 9098002758 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1841, BLUE JAY |
| State: | CA |
| Postal Code: | 923171841 |
| Phone Number: | 9098002758 |
| Fax Number: | |
| NPI Enumeration Date: | 02/29/2016 |
| NPI Last Update Date: | 02/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 167400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |