Individual provider Active NPI

Lisa M Plocher, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Culver City, CA
National Provider Identifier
1871826057
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95005944 Issued in CA
Practice address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone
(310) 390-6612
NPI assigned
Sep 6, 2009
Last updated
Oct 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA10878 OH
Family Nurse Practitioner 363LF0000X 95005944 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95005944 CA Primary

Addresses

Primary practice location

4760 Sepulveda Blvd
Culver City, CA 90230-4820

Mailing address

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612

Other practice location 1

29133 Health Campus Dr
Westlake, OH 44145-5256
Phone (440) 835-6212

Other practice location 2

5455 Wilshire Ave 1802
los angeles, CA 90036-2011
Phone (323) 297-0700

Other practice location 3

2505 Santa Monica Blvd
Santa Monica, CA 90404-2011
Phone (310) 828-6456

Other identifiers 1

IdentifierTypeStateIssuer
2990072MedicaidOH

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
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95005944CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Socal Flu Shots Past Accepting new patients
Passport Health Los Angeles Past Accepting new patients
Geriatric Nurse Practitioners, Inc. Nurse Practitioner Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1252195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1871826057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 SEPULVEDA BLVD",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304820",
            "telephone_number": "310-390-6612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29133 Health Campus Dr",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441455256",
            "country_code": "US",
            "telephone_number": "440-835-6212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5455 Wilshire Ave 1802",
            "address_purpose": "LOCATION",
            "city": "los angeles",
            "state": "CA",
            "postal_code": "900362011",
            "country_code": "US",
            "telephone_number": "323-297-0700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2505 Santa Monica Blvd",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904042011",
            "country_code": "US",
            "telephone_number": "310-828-6456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLOCHER",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-06",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA10878",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005944",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95005944",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2990072",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.