Lisa Gaye Quan, RN BSN CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

RN351114 Issued in CA

Practice address

20103 Lake Chabot Rd
Castro Valley, CA 94546-5305

Phone

(510) 727-3032

Fax

(510) 583-7624

NPI assigned

Nov 8, 2017

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

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1922511278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19250 CLEMENT DR",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945525040",
            "telephone_number": "510-502-0090",
            "fax_number": "510-583-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465305",
            "telephone_number": "510-727-3032",
            "fax_number": "510-583-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN",
        "first_name": "LISA",
        "middle_name": "GAYE",
        "credential": "RN BSN CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CA",
            "license": "RN351114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diabetes Educator Registered Nurse in Castro Valley, CA
• Providers in Castro Valley, CA by specialty
• Diabetes Educator Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; 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.