Nedaa N Issa, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

152298 Issued in CA

Practice address

1901 W Kettleman LN Ste 200
Lodi, CA 95242-4337

Phone

(209) 334-8540

Fax

(209) 368-2885

NPI assigned

Apr 9, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: nedaa.issa.p1@direct.cmcentersinc.nextgenshare.com

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1043453814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W KETTLEMAN LN STE 200",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424337",
            "telephone_number": "209-334-8540",
            "fax_number": "209-368-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W KETTLEMAN LN STE 200",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424337",
            "telephone_number": "209-334-8540",
            "fax_number": "209-368-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSA",
        "first_name": "NEDAA",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-09",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "24915",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "152298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023942",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innovative Senior Rehabilitation Services, Inc. (Innovative Senior Rehab)
• Inpatient Services of California, Inc., a Medical Corporation
• Iris VND Partners LLC (Balance Assisted Living and Memory Care)
• Anthony Isbell
• Roy Tsutomu Ishii, MD
• Winter Anne Ives, DPT
• Carol Jacinto
• Karen Ann Jacka
• Amber Jackson
• Melissa Jackson, LMFT

• Pediatrics Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.