Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lisa Russo Pettigrew, RSMT, PHDCANDIDATE

Individual provider Community Health Worker · NPI 1356128029

Lisa Russo Pettigrew, RSMT, PHDCANDIDATE is a Community Health Worker in Crestline, California. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2

Practice location Address checks out

340 S State Highway 138
Crestline, CA 92325-9153
Phone: (909) 336-3330
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychoanalyst (primary) Taxonomy 102L00000X
Community Health Worker Taxonomy 172V00000X

Record details

NPI number1356128029
Entity typeIndividual (Type 1)
GenderFemale
Credentials RSMT , PHDCANDIDATE
Sole proprietorNo
NPI enumeratedSeptember 14, 2023
Last updated in NPPESFebruary 6, 2025
Certification dateFebruary 6, 2025

Other providers in Crestline