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

Mr. Ross Lisman Jr., PHD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104375419

Mr. Ross Lisman Jr., PHD is a Student in an Organized Health Care Education/Training Program in San Dimas, California. Works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2016
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

304 Beechwood Ln
San Dimas, CA 91773-3605
Phone: (614) 205-8454
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 180 N Oakland Ave, Pasadena, CA 91101-1714 — (626) 584-5555

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 32416 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104375419
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedSeptember 27, 2016
Last updated in NPPESDecember 21, 2022
Certification dateDecember 21, 2022

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