Petronella W Lip, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN294328 Issued in CA

Practice address

535 W Mathews Rd
French Camp, CA 95231-9757

Phone

(209) 468-4267

NPI assigned

Aug 13, 2013

Sex

Female

Sole proprietor

Yes

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

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.

• County of San Joaquin

  • Custodial Care Facility
  • French Camp, CA
  • NPI 1063248342
  NPD (past)

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1679906606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 W MATHEWS RD",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319757",
            "telephone_number": "209-468-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W MATHEWS RD",
            "city": "FRENCH CAMP",
            "state": "CA",
            "postal_code": "952319757",
            "telephone_number": "209-468-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIP",
        "first_name": "PETRONELLA",
        "middle_name": "W",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN294328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Lee Lewis
• Louis Lim, M.D.
• Ashley Lin
• Christopher M Lindeken, D.O.
• Jeffrey Alan Lindenberg, MD
• Shih-Dun Liu, M.D.
• Peter Lo, MD
• Aimee Marie Loebs
• Pamela D. Long, C.N.M.W.
• Angelica Imer Lopez

• Registered Nurse in French Camp, CA
• Providers in French Camp, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.