Lisa Randolph

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95002336 Issued in CA

Practice address

1010 Murray Ave
San Luis Obispo, CA 93405-1806

Phone

(805) 546-7600

NPI assigned

Aug 12, 2015

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

Other names 1

• Lisa M Ecker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1114393279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4562 OBISPO RD",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934221531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MURRAY AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051806",
            "telephone_number": "805-546-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "ECKER",
            "middle_name": "M",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jordyn Ramos
• Louis Ramos, LMFT
• Leigh M Ramsey, LPCC
• Randall L Lonsbrough D D S Inc
• Jackson Randolph, MD
• Hans Rankin, M.D.
• Samantha Jane Rankin
• Niki Brook Rarig, ND, LAC
• Josh Raser
• Melissa Rasmussen, PT, DPT

• Family Nurse Practitioner in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.