| Doctor Name: | MS. LISA AMAVISCA |
| NPI Number: | 1720126428 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | RPE4222 |
| Business Practice Address: | 750 F St Ste 2 Davis, CA - 956163738 |
| Business Phone Number: | 5307588944 |
| Business Fax Number: | 5307584302 |
| Mailing Address: | 2955 Leonor Dr, SACRAMENTO |
| State: | CA |
| Postal Code: | 958332801 |
| Phone Number: | 9163592752 |
| Fax Number: | |
| NPI Enumeration Date: | 02/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | RPE4222 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |