Individual provider Active NPI

Angela Lis, FNP-C

  • Family Nurse Practitioner
  • Palo Alto, CA
National Provider Identifier
1245758978
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95006491 Issued in CA
Practice address
195 Page Mill Rd Ste 103
Palo Alto, CA 94306-2073
Phone
(888) 731-8994
NPI assigned
Sep 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP.0034610 OH
Family Nurse Practitioner 363LF0000X 9466449 FL
Family Nurse Practitioner 363LF0000X 95006491 CA Primary

Addresses

Primary practice location

195 Page Mill Rd Ste 103
Palo Alto, CA 94306-2073

Mailing address

14355 Miranda Way
Los Altos Hills, CA 94022-2032

Other practice location 1

500 Ala Moana Blvd Ste 7400
Honolulu, HI 96813-4902
Phone (888) 731-8994

Other practice location 2

111 N Orange Ave Ste 800
Orlando, FL 32801-2381
Phone (888) 731-8994

Other practice location 3

21 E State St Ste 200
Columbus, OH 43215-0109
Phone (888) 731-8994

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

LicenseStateTypeSpecialty
95006491CAMDFamily Nurse Practitioner
9466449FLMDFamily Nurse Practitioner
CNP.0034610OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Womens Care PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: angela.lis.1@27069.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1245758978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14355 MIRANDA WAY",
            "city": "LOS ALTOS HILLS",
            "state": "CA",
            "postal_code": "940222032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 PAGE MILL RD STE 103",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943062073",
            "telephone_number": "888-731-8994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Ala Moana Blvd Ste 7400",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968134902",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 N Orange Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328012381",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 E State St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432150109",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIS",
        "first_name": "ANGELA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-01",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "CNP.0034610",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9466449",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95006491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

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