Agustin Lizama

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

130 W. Bruno St
Los Angeles, CA 90012

Phone

(323) 526-1254

NPI assigned

Aug 29, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Homeboy Industries

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1588185128
  NPD (past)

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1558610147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2677 MOSS AVE #7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90065",
            "telephone_number": "323-526-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W. BRUNO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90012",
            "telephone_number": "323-526-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZAMA",
        "first_name": "AGUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Livingstone, D.C.
• Stephanie Leigh Livshitz, PSYD
• Alice Liwag
• Erickson Dizon Liwag, NP-C
• Jaime Liwag
• Antoinette Marie Lizama
• Wuelmer C Lizama
• Brittany Lizaola
• Delsie Lizaola
• Lastasia Lizardo

• Case Manager/Care Coordinator in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.