Lisa Marie Nevitt, PA-C
Individual provider Active NPI Physician Assistant · San Jose, CA
NPI 1326489014 · NPPES record last updated Nov 24, 2014
Key facts
- NPI
- 1326489014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA22923 (CA)
- Practice address
- 455 Oconnor Dr
Suite 150
San Jose, CA 95128-1633 - Phone
- (408) 298-8770
- Fax
- (408) 298-8710
- NPI assigned
- Jul 10, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA22923 | CA | Yes |
Addresses
Primary practice location
455 Oconnor Dr
Suite 150
San Jose, CA 95128-1633
Mailing address
400 Race St
San Jose, CA 95126-3518
Phone (408) 278-3500
Other providers in San Jose, CA
- Raquel Liza Nevarez
- Ginger Neven
- Scott Neven
- Charlyn Joy Neverida
- Dana Beryl Nevin
- Ruth Nevo
- New Century Pain Clinic
- New Day Nutrition, LLC
- New Focus Marriage & Family Counseling Inc
- New Hope Chiropractic, Inc.
All providers in San Jose, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.