Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LISA RUSSO PETTIGREW, RSMT, PHD. CANDIDATE
ActiveLISA RUSSO PETTIGREW, RSMT, PHD. CANDIDATE is a Psychoanalyst healthcare provider located in CRESTLINE, California. NPI 1356128029 is currently active in the NPPES registry. Verify at CMS.
Psychoanalyst · CRESTLINE, CA
Registration Details
- NPI Number
- 1356128029
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 14, 2023 (2.9305178721864 yrs)
- Last Updated
- Feb 6, 2025
Practice Information
- Address
-
340 S STATE HIGHWAY 138CRESTLINE, CA, 923259153Browse CA providers · Browse ZIP 92325
- Phone
- 9093363330
- Primary Specialty
-
Psychoanalyst
102L00000X
- Additional Specialty
- Psychoanalyst
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.