Individual provider Active NPI

Elizabeth Anne Sivesind, P.A.-C.

  • Physician Assistant
  • Lafayette, CA
National Provider Identifier
1629318951
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA010420 Issued in CA
Practice address
911 Moraga Rd.
201
Lafayette, CA 94549
Phone
(925) 284-3040
Fax
(925) 283-6087
NPI assigned
Feb 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA010420 CA Primary

Addresses

Primary practice location

911 Moraga Rd.
201
Lafayette, CA 94549

Mailing address

911 Moraga Rd.
201
Lafayette, CA 94549
Phone (925) 284-3040

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA010420CAMDPhysician Assistant
10420CAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1361577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1629318951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 MORAGA RD.",
            "address_2": "201",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "94549",
            "telephone_number": "925-284-3040",
            "fax_number": "925-283-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 MORAGA RD.",
            "address_2": "201",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "94549",
            "telephone_number": "925-284-3040",
            "fax_number": "925-283-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVESIND",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-23",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA010420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.