Individual provider Active NPI

Lisa Renee Bretches, N.P.

  • Pediatric Nurse Practitioner
  • Mission Viejo, CA
National Provider Identifier
1477890242
Registry record updated Jan 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
388136 Issued in CA
Practice address
27800 Medical Center Rd
Suite 300
Mission Viejo, CA 92691-6410
Phone
(949) 364-2229
NPI assigned
Jan 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 388136 CA Primary

Addresses

Primary practice location

27800 Medical Center Rd
Suite 300
Mission Viejo, CA 92691-6410

Mailing address

1064 Smoketree Dr
Corona, CA 92882-8783
Phone (951) 733-9552

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
388136CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gubbi T Mruthyunjaya Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1358035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358035200000",
    "number": "1477890242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 SMOKETREE DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928828783",
            "telephone_number": "951-733-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD",
            "address_2": "SUITE 300",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916410",
            "telephone_number": "949-364-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETCHES",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-13",
        "last_updated": "2013-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "388136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2013; 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.