Individual provider Active NPI

Lisa Shalee Quidor

  • Hearing Instrument Specialist
  • San Juan Capistrano, CA
National Provider Identifier
1871352807
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
4087 Issued in CA
Practice address
31878 Del Obispo St Ste 111
San Juan Capistrano, CA 92675-3223
Phone
(949) 558-5051
NPI assigned
Mar 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 4087 CA Primary

Addresses

Primary practice location

31878 Del Obispo St Ste 111
San Juan Capistrano, CA 92675-3223

Mailing address

31878 Del Obispo St Ste 111
San Juan Capistrano, CA 92675-3223
Phone (949) 558-5051

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

LicenseStateTypeSpecialty
4087CAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1871352807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31878 DEL OBISPO ST STE 111",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753223",
            "telephone_number": "949-558-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31878 DEL OBISPO ST STE 111",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926753223",
            "telephone_number": "949-558-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIDOR",
        "first_name": "LISA",
        "middle_name": "SHALEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "4087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.