Lisette Santos Del Mar, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

29496 Issued in CA

Practice address

3820 Martin Luther King Jr Blvd
Lynwood, CA 90262-3625

Phone

(310) 632-0415

NPI assigned

Mar 8, 2018

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

Other names 1

• Ms. Lisette Farrales Santos Former name

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": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1457854101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23426 MEHDEN AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907455222",
            "telephone_number": "310-291-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MARTIN LUTHER KING JR BLVD",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623625",
            "telephone_number": "310-632-0415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23426 Mehden Ave",
            "address_purpose": "LOCATION",
            "city": "Carson",
            "state": "CA",
            "postal_code": "907455222",
            "country_code": "US",
            "telephone_number": "310-291-7599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEL MAR",
        "first_name": "LISETTE",
        "middle_name": "SANTOS",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "29496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISETTE",
            "last_name": "SANTOS",
            "middle_name": "FARRALES",
            "prefix": "MS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason De Leon
• Yessica Yesenia De Leon
• Christy Dean
• Yolanda Debato
• Yolanda Dees
• Janet Del Real
• Jason Douglas Delacuz
• Eneida Delgado
• Steve B Delgado
• Monica A Derbigny, MD

• Physical Therapist in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.