Active NPI
Lissa Wynne Sturdevant, NP
- Nurse Practitioner
- San Francisco, CA
National Provider Identifier
1205930831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP15915
- Practice address
- 995 Potrero Ave
Ward 86
San Francisco, CA 94110-2859 - Phone
- (415) 476-4082
- Fax
- (415) 476-8881
- NPI assigned
- Sep 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NP15915 | CA | Primary |
Addresses
Primary practice location
995 Potrero Ave
Ward 86
San Francisco, CA 94110-2859
Mailing address
995 Potrero Ave
Ward 86
San Francisco, CA 94110-2859
Phone (415) 476-4082
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15915 | CA | MD | Speech-Language Pathologist |
| NP15915 | CA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199664000000",
"number": "1205930831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "995 POTRERO AVE",
"address_2": "WARD 86",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941102859",
"telephone_number": "415-476-4082",
"fax_number": "415-476-8881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "995 POTRERO AVE",
"address_2": "WARD 86",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941102859",
"telephone_number": "415-476-4082",
"fax_number": "415-476-8881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STURDEVANT",
"first_name": "LISSA",
"middle_name": "WYNNE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-12",
"last_updated": "2008-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NP15915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.