Individual provider Active NPI

Lysandra Jenel Lebaron

  • Student in an Organized Health Care Education/Training Program
  • San Tan Valley, AZ
National Provider Identifier
1316809064
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2163 W Emrie Ave
San Tan Valley, AZ 85144-1414
Phone
(480) 758-7242
NPI assigned
Dec 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ Primary

Addresses

Primary practice location

2163 W Emrie Ave
San Tan Valley, AZ 85144-1414

Mailing address

2163 W Emrie Ave
San Tan Valley, AZ 85144-1414

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1316809064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2163 W EMRIE AVE",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851441414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2163 W EMRIE AVE",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851441414",
            "telephone_number": "480-758-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBARON",
        "first_name": "LYSANDRA",
        "middle_name": "JENEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Tan Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.