Individual provider Active NPI

Kimberly Rochelle Lizama, MSN

  • Registered Nurse
  • Fremont, CA
National Provider Identifier
1437569183
Registry record updated Jan 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
711752 Issued in CA
Practice address
39001 Sundale Dr
Fremont, CA 94538-2005
Phone
(510) 796-1100
NPI assigned
May 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 711752 CA Primary

Addresses

Primary practice location

39001 Sundale Dr
Fremont, CA 94538-2005

Mailing address

770 Chippewa Way
Livermore, CA 94551-1643
Phone (510) 825-9500

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)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
711752CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1399075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453075200000",
    "number": "1437569183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 CHIPPEWA WAY",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945511643",
            "telephone_number": "510-825-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39001 SUNDALE DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382005",
            "telephone_number": "510-796-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZAMA",
        "first_name": "KIMBERLY",
        "middle_name": "ROCHELLE",
        "name_prefix": "Mrs.",
        "credential": "MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-03",
        "last_updated": "2016-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "711752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; 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.