Lisa Nicholson, NP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

17370 Issued in CA

Practice address

200 Medical Plaza Suite 265
Los Angeles, CA 90095

Phone

(310) 794-5066

NPI assigned

Jul 17, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Sanjiv Verma MD Inc

  • Allergy Physician
  • Ventura, CA
  • NPI 1154351963
  NPD (past)

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527811200000",
    "number": "1295934479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA SUITE 265",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-794-5066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3291 Loma Vista Rd",
            "address_purpose": "LOCATION",
            "city": "Ventura",
            "state": "CA",
            "postal_code": "930033099",
            "country_code": "US",
            "telephone_number": "805-652-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2018-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "CA",
            "license": "17370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF REGIS",
            "identifier": "409782",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Phifer Nicholson Jr., MD, MTS
• Denise Darcel Nicholson, AU.D.
• Jamie Lee Nicholson
• Kathleen Nicholson
• Lindsey Rachel Nicholson
• Luke Nicholson, M.D.
• Shaina M. Nicholson, MSW
• Willie Nicholson
• Nick a. Agpalo, D.M.D., Inc.
• Andrew Nickel, DDS

• Neonatal Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neonatal Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2018; 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.