Lisa Anne Sedillo, ARRT R M, RDMS

Primary specialty

Sonography Radiologic TechnologistTaxonomy code 2471S1302X

License

17109 Issued in CA

Practice address

1360 W 6TH St
San Pedro, CA 90732-3514

Phone

(310) 514-5243

NPI assigned

Oct 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193443200000",
    "number": "1275721540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1367 W 20TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907324407",
            "telephone_number": "310-832-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323514",
            "telephone_number": "310-514-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDILLO",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "ARRT R M, RDMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "CA",
            "license": "155559",
            "primary": false
        },
        {
            "code": "2471M2300X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Mammography",
            "state": "CA",
            "license": "41845",
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "CA",
            "license": "17109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sonography Radiologic Technologist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Sonography Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; 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.