Lisa Lynn Rezner

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

114390 Issued in CA

Practice address

17772 Irvine Blvd Ste 102
Tustin, CA 92780-3233

Phone

(714) 401-9968

NPI assigned

Oct 4, 2020

Last updated

Nov 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 9, 2024 through Jan 9, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1063019982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17772 IRVINE BLVD STE 102",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803233",
            "telephone_number": "714-401-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17772 IRVINE BLVD STE 102",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803233",
            "telephone_number": "714-401-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNER",
        "first_name": "LISA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-04",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sully Reyes
• Madelyn Kent Reynolds
• Livan Reynoso
• Sahar Rezaei, PHARM.D.
• Fady Rezk
• Seyoon Rhee, DC
• Sumin Rhee, DDS
• Randall Craig Rheinheimer, PH.D., MFT
• Reata Lyn Rhine, LCSW
• Kristin Catherine Rhodes, NP

• Marriage & Family Therapist in Tustin, CA
• Providers in Tustin, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.