Provider Demographics
NPI:1215060991
Name:MCJUNKIN, LISA CAROLYN (LMFT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:CAROLYN
Last Name:MCJUNKIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:CAROLYN
Other - Last Name:MALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1602 JOSE LN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-2051
Mailing Address - Country:US
Mailing Address - Phone:619-987-0158
Mailing Address - Fax:
Practice Address - Street 1:1602 JOSE LN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-2051
Practice Address - Country:US
Practice Address - Phone:619-987-0158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2023-11-18
Deactivation Date:2023-09-21
Deactivation Code:
Reactivation Date:2023-10-31
Provider Licenses
StateLicense IDTaxonomies
CA50842106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist