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MR. ROSS LISMAN JR. PHD
NPI 1104375419
Psychologist - Clinical in San Dimas, CA

Active since September 27, 2016
304 BEECHWOOD LN, SAN DIMAS, CA 91773(614) 205-8454 Get Directions Write a Review

NPPES record last updated: December 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 21, 2022, Sep 27, 2016 (2 updates tracked since 2016).

About Mr. Ross Lisman Jr. Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. ROSS LISMAN JR. PHD (NPI 1104375419) is an individual clinical provider in San Dimas, California, licensed in California (32416) and active in the NPI registry since September 2016. He maintains a secondary practice location in Pasadena.

NPPES Registry Identity

NPI1104375419
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameMR. ROSS LISMAN JR.Credential: PHD
Location Address304 BEECHWOOD LNSan Dimas, CA 91773-3605
Mailing AddressPo Box 4153San Dimas, CA 91773-8153
Phone(614) 205-8454
Sole ProprietorNo
Enumeration DateSeptember 27, 2016
Last NPPES UpdateDecember 21, 20222 updates tracked since enumeration
NPPES CertifiedDecember 21, 2022
✔ NPI 1104375419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 32416
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
304 BEECHWOOD LN, San Dimas, CA 91773
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Secondary Practice Location 1

Location 1180 N Oakland AvePasadena, CA 91101-1714 · Phone (626) 584-5555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ross Lisman's NPI number?

The NPI number for Ross Lisman is 1104375419. It was assigned to this individual provider in the NPPES registry on September 27, 2016.

Where is Ross Lisman located?

Ross Lisman practices at 304 Beechwood Ln, San Dimas, CA 91773. The listed phone number is (614) 205-8454.

What is Ross Lisman's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Ross Lisman was last updated on December 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.