Lisa Dawn Gibbs, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

814892 Issued in CA

Practice address

2050 Fairmont Dr
San Leandro, CA 94578-1001

Phone

(510) 895-5502

Fax

(510) 895-7407

NPI assigned

Dec 10, 2021

Sex

Female

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1609535376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 RAVENWOOD PL",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945466015",
            "telephone_number": "510-329-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 FAIRMONT DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781001",
            "telephone_number": "510-895-5502",
            "fax_number": "510-895-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "LISA",
        "middle_name": "DAWN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "CA",
            "license": "814892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gi Ghevariya PC
• Anthony Giang
• Paul Son Giang, PHARMD
• Erica Lindsay Gibbert
• Andreia Gwenette Gibbs
• Paul Mark Gibson, LCSW
• Robin Gibson
• Bridgette Heidi Gifford
• Andrea Gil
• Jesenia Janeth Gil, LCSW

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in San Leandro, CA
• Providers in San Leandro, CA by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.