Lorri Jan Cerva-Bucholz, DO

Primary specialty

SpecialistTaxonomy code 174400000X

License

4313 Issued in AZ

Practice address

19636 N 27TH Avenue
Suite 106
Phoenix, AZ 85027

Phone

(623) 516-8252

Fax

(623) 516-8253

NPI assigned

Sep 30, 2006

Last updated

Jul 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1427141845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5281 N 99TH AVE",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053105",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVENUE",
            "address_2": "SUITE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85027",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVA-BUCHOLZ",
        "first_name": "LORRI",
        "middle_name": "JAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "4313",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "4313",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4313",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "974528",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa A Cerilli, MD
• Michelle L Cermak
• Stephanie Ceron Guicho, LMSW
• Certified Medical Transportation
• Certified PA LLC
• Maraya Cervantes Chavira
• Roxann Cervantes
• Ruby A. Cervantes, LPC
• Emily Susan Cervantez, RDN
• Samara Cerven, PSY.D

• Specialist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.