Provider Demographics
NPI:1386057826
Name:BJORKLUND, LISA
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:BJORKLUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 E HEDGES AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93728-1737
Mailing Address - Country:US
Mailing Address - Phone:559-349-7988
Mailing Address - Fax:
Practice Address - Street 1:657 E HEDGES AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93728-1737
Practice Address - Country:US
Practice Address - Phone:559-349-7988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94020120103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94020120OtherBOARD OF PSYCHOLOGY