Active NPI
Lissa-Ann Portorreal, PT
- Physical Therapist
- Hemet, CA
National Provider Identifier
1851671572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 41947
- Practice address
- 1350 E Devonshire Ave
Hemet, CA 92544-8629 - Phone
- (951) 925-2571
- NPI assigned
- Aug 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 15571 | CA | |
| Physical Therapist | 225100000X | 41947 | CA | Primary |
Addresses
Primary practice location
1350 E Devonshire Ave
Hemet, CA 92544-8629
Mailing address
2600 S Main St
Corona, CA 92882-5941
Phone (951) 736-4700
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41947 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1851671572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 S MAIN ST",
"city": "CORONA",
"state": "CA",
"postal_code": "928825941",
"telephone_number": "951-736-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 E DEVONSHIRE AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "925448629",
"telephone_number": "951-925-2571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTORREAL",
"first_name": "LISSA-ANN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-25",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "15571",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "41947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.