Individual provider Active NPI

Lisa Hersam, RN

  • Pediatric Oncology Registered Nurse
  • Sacramento, CA
National Provider Identifier
1023607348
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Oncology Registered NurseTaxonomy code 163WP0218X
License
557147 Issued in CA
Practice address
2279 45TH St
Sacramento, CA 95817-1514
Phone
(916) 734-5959
NPI assigned
Jan 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Oncology Registered Nurse 163WP0218X 557147 CA Primary

Addresses

Primary practice location

2279 45TH St
Sacramento, CA 95817-1514

Mailing address

991 Moonlit Way
Folsom, CA 95630-7506
Phone (916) 734-5959

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lmhersam@ucdavis.edu Direct
Direct Messaging Address lmhersam@ucdavis.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
557147CAMDPediatric Oncology Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1023607348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 MOONLIT WAY",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956307506",
            "telephone_number": "916-734-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 45TH ST",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171514",
            "telephone_number": "916-734-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSAM",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "CA",
            "license": "557147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmhersam@ucdavis.edu",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2279 45th St",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958171514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmhersam@ucdavis.edu",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2279 45th St",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958171514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.