DR. LISA NICHOLE ODOM PSY.D
NPI 1801108345
Student in an Organized Health Care Education/Training Program in Alpine, CA

Q: What is Lisa Odom's NPI number?

The NPI number for Lisa Odom is 1801108345. It was assigned to this individual provider in the NPPES registry on July 13, 2010. The provider is also known as Lisa Nichole Jacobsen M.A..

Q: What is Lisa Odom's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Odom was last updated on February 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 13, 2010

2120 ALPINE BLVD., 2120 ALPINE BOULEVARD, ALPINE, CA 91901(619) 544-0633 Get Directions Write a Review

NPPES record last updated: February 10, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Lisa Nichole Odom Psy.d NPPES

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

DR. LISA NICHOLE ODOM PSY.D (NPI 1801108345) is an individual student in an organized health care education/training program in Alpine, California and active in the NPI registry since July 2010.

NPPES Registry Identity

NPI1801108345

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. LISA NICHOLE ODOMCredential: PSY.D

Location Address2120 ALPINE BLVD., 2120 ALPINE BOULEVARDAlpine, CA 91901

Mailing Address2120 Alpine BlvdAlpine, CA 91901-2113 · (619) 544-0633

Phone(619) 544-0633

Sole ProprietorNo

Enumeration DateJuly 13, 2010

Last NPPES UpdateFebruary 10, 2014

✔ NPI 1801108345 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

2120 ALPINE BLVD., Alpine, CA 91901

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Other Names 1

Former Name (1)Lisa Nichole Jacobsen M.a.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA LYNNE FONTE LAC

Counselor

2120 ALPINE BLVD., ALPINE SPECIAL TREATMENT CENTER
ALPINE, CA 91901

San Diego County (619) 659-3120

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 Lisa Odom's NPI number?

The NPI number for Lisa Odom is 1801108345. It was assigned to this individual provider in the NPPES registry on July 13, 2010. The provider is also known as Lisa Nichole Jacobsen M.A..

Where is Lisa Odom located?

Lisa Odom practices at 2120 Alpine Blvd. 2120 Alpine Boulevard, Alpine, CA 91901. The listed phone number is (619) 544-0633.

What is Lisa Odom's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Lisa Odom was last updated on February 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.