Lystra Paul

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

15447 Anacapa Rd Ste 102D2
Victorville, CA 92392-2481

Phone

(909) 654-0798

Fax

(800) 915-8151

NPI assigned

Jun 11, 2025

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1205721909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15447 ANACAPA RD STE 102D2",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922481",
            "telephone_number": "909-654-0798",
            "fax_number": "800-915-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15447 ANACAPA RD STE 102D2",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922481",
            "telephone_number": "909-654-0798",
            "fax_number": "800-915-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAUL",
        "first_name": "LYSTRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "Simple Practice",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "15447 Anacapa Rd Ste 102D2",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923922481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jada Patterson
• Nicole Patterson
• Rechelle Patterson, DOULA
• Paul Kim Optometry Victorville a Professional Corporation
• Paul White M.D. Inc.
• Sheila Adriana Paul, LMFT
• Tomasz J Pawlowski, MD
• Cesar Payan, PTA
• Stephanie Monique Paz
• William Edward Pazdral, M.D.

• Community Health Worker in Victorville, CA
• Providers in Victorville, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.