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

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: July 19, 2026.

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

What is Lisa Odom's NPI number?

The NPI number assigned to this healthcare provider is 1801108345, enumerated as an "individual" on July 13, 2010.

Where is the provider located?

The provider is located at 2120 ALPINE BLVD. 2120 ALPINE BOULEVARD ALPINE, CA 91901 and the phone number is (619) 544-0633.

What is the provider's specialty?

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.