Lisa Ann Moore, AGPCNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

95031277 Issued in CA

Practice address

360 Dogwood Dr
Buellton, CA 93427-6809

Phone

(805) 453-4218

NPI assigned

Jun 2, 2026

Last updated

Jun 2, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1932031168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 DOGWOOD DR",
            "city": "BUELLTON",
            "state": "CA",
            "postal_code": "934276809",
            "telephone_number": "805-453-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 DOGWOOD DR",
            "city": "BUELLTON",
            "state": "CA",
            "postal_code": "934276809",
            "telephone_number": "805-453-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95031277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Longevity Care Providers Inc
• Longs Drug Stores California LLC (CVS Pharmacy #09970)
• Madalyn Michelle Mainhardt
• Cynthia Redfern Mikelson, LAC
• Tamara Mitterer, PHARMD
• Cherieka Juanae Morgan-Gossett
• Sarah Beth Rasmussen, WHNP, NM
• Sherry Reyes
• Mike Rhoades, PARAMEDIC
• S B Health Care Acquisition Inc (Santa Barbara Healthcare)

• Gerontology Nurse Practitioner in Buellton, CA
• Providers in Buellton, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; 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.