Lisette Fuentes

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95002194 Issued in CA

Practice address

22331 Mission Blvd
Hayward, CA 94541-3911

Phone

(510) 471-5907

Fax

(510) 690-0703

NPI assigned

Aug 24, 2015

Last updated

Aug 24, 2015By the provider in NPPES

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• City & County of San Francisco

  dba San Francisco Public Health Laboratory

  • Clinical Medical Laboratory
  • San Francisco, CA
  • NPI 1982737524
  Medicare reassignment NPD
• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment NPD
• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1831268580
  Medicare reassignment NPD
• City & County of San Francisco

  dba CCSF DPH Multi - Practice Medical Group

  • Community Health/Public Health Clinical Nurse Specialist
  • San Francisco, CA
  • NPI 1609041060
  NPD
• City and County of San Francisco

  dba DSAAM OTOP Methadone Maintenance

  • Methadone Clinic
  • San Francisco, CA
  • NPI 1578787925
  NPD
• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1417324690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22331 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413911",
            "telephone_number": "510-471-5907",
            "fax_number": "510-690-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22331 MISSION BLVD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945413911",
            "telephone_number": "510-471-5907",
            "fax_number": "510-690-0703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "LISETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95002194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice A Friesen, L.C.S.W.
• Stephanie Frigault
• Bria Frison
• Chih-Shang Fu
• Diana Fuentes
• Caitlin Fuhriman
• Sanara Fulmore
• Stephanie Man-CHI Lee Fung, M.D.
• Thomas Ying Kit Fung, M.D.
• Jennifer Funk

• Adult Health Nurse Practitioner in Hayward, CA
• Providers in Hayward, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.