Individual provider Active NPI

Lisa Morales, FNP

  • Family Nurse Practitioner
  • Victorville, CA
National Provider Identifier
1619456449
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95009341 Issued in CA
Practice address
17259 Jasmine St
Victorville, CA 92395-7787
Phone
(760) 843-9414
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009341 CA Primary

Addresses

Primary practice location

17259 Jasmine St
Victorville, CA 92395-7787

Mailing address

17767 Cabazon Rd
Apple Valley, CA 92307-2121
Phone (760) 987-8858

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lisamorales@sjhhandhmg.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190828003500 CA Practitioner - Nurse Practitioner 7113255159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

19333 Bear Valley Rd
Suite 101
Apple Valley, CA 92308-5149
Phone (760) 240-6749

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95009341CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jul 29, 2019 Accepting new patients
Providence Medical Foundation CurrentSince Jul 29, 2019 Accepting new patients
St. Mary Medical Center Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
St Mary Specialty Clinic Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

19333 Bear Valley Rd
Ste 205
Apple Valley, CA 92308
Phone (760) 247-4155

19333 Bear Valley Rd
Ste 101
Apple Valley, CA 92308
Phone (760) 240-3784

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

12550 Hesperia Rd
Ste 100
Victorville, CA 92395

Organizations & group practices 6

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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1619456449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17767 CABAZON RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072121",
            "telephone_number": "760-987-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17259 JASMINE ST",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957787",
            "telephone_number": "760-843-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "LISA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisamorales@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "17259 Jasmine St",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923957787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.