Lisa Michelle Andrade, RN

Individual provider Active NPI Diabetes Educator Registered Nurse · French Camp, CA

NPI 1942921028 · NPPES record last updated Sep 7, 2022

Key facts

NPI
1942921028
Entity type
Individual (NPI type 1)
Primary specialty
Diabetes Educator Registered Nurse 163WD0400X
License
501791 (CA)
Practice address
500 W Hospital Rd
French Camp, CA 95231-9693
Phone
(209) 953-5424
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
501791CAMDDiabetes Educator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 501791 CA Yes

Addresses

Primary practice location

500 W Hospital Rd
French Camp, CA 95231-9693

Mailing address

10100 Trinity Pkwy Ste 100
Stockton, CA 95219-7239
Phone (209) 953-5424

Other identifiers

IdentifierTypeStateIssuer
94-3040535OtherCASAN JOAQUIN HEALTH CLINICS

Other providers in French Camp, CA

All providers in French Camp, CA · Diabetes Educator Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.