Individual provider Active NPI

Lisa M Portera-Perry, D.C.

  • Nutrition Chiropractor
  • Walnut Creek, CA
National Provider Identifier
1376853903
Registry record updated Oct 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CA16815 Issued in CA
Practice address
1299 Newell Hill PL Ste 102
Walnut Creek, CA 94596-5230
Phone
(925) 683-8478
NPI assigned
Oct 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X CA16815 CA Primary

Addresses

Primary practice location

1299 Newell Hill PL Ste 102
Walnut Creek, CA 94596-5230

Mailing address

1299 Newell Hill PL Ste 102
Walnut Creek, CA 94596-5230
Phone (925) 683-8478

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

State licenses

LicenseStateTypeSpecialty
CA16815CAMDNutrition Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1287273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287273600000",
    "number": "1376853903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 NEWELL HILL PL STE 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965230",
            "telephone_number": "925-683-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 NEWELL HILL PL STE 102",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945965230",
            "telephone_number": "925-683-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTERA-PERRY",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-17",
        "last_updated": "2010-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "CA16815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2010; 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.