Individual provider Active NPI

Lisa Acosta, MD

  • Child & Adolescent Psychiatry Physician
  • Simi Valley, CA
National Provider Identifier
1497887277
Registry record updated May 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
A89108 Issued in CA
Practice address
1227 E Los Angeles Ave
Simi Valley, CA 93065-2871
Phone
(805) 582-4080
Fax
(805) 579-6010
NPI assigned
Mar 9, 2007
Last updated
May 1, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X A89108 CA Primary

Addresses

Primary practice location

1227 E Los Angeles Ave
Simi Valley, CA 93065-2871

Mailing address

1227 E Los Angeles Ave
Simi Valley, CA 93065-2871
Phone (805) 582-4080

Other names 1

  • Dr. Lisa Acosta Professional name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A89108CAMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1497887277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 E LOS ANGELES AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652871",
            "telephone_number": "805-582-4080",
            "fax_number": "805-579-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 E LOS ANGELES AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652871",
            "telephone_number": "805-582-4080",
            "fax_number": "805-579-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "A89108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "ACOSTA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.