Nicole Marie Lithgow, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34407 Issued in CA

Practice address

3540 Mendocino Ave Ste 200
Santa Rosa, CA 95403-3639

Phone

(707) 522-6200

NPI assigned

Sep 21, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1569024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569024000000",
    "number": "1407407471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 MENDOCINO AVE STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 MENDOCINO AVE STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033639",
            "telephone_number": "707-522-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3540 Mendocino Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954033639",
            "country_code": "US",
            "telephone_number": "707-522-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITHGOW",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-21",
        "last_updated": "2019-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Lippard, RD
• Lisa B. Kremer, M.D.
• Lisa R Grossman PHD Psychologist a Professional Corporation
• Stephanie Lisius
• Doug J Lisle, P.H.D.
• Karen Helene Littell, MSW, LCSW, PPSC
• Deborah K Little Bear
• Jerry Chia Ye Liu
• Joseph Liu, D.C., QME
• Yuhong Liu, PHARMD

• Optometrist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2019; 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.