Lisa Nicole Mazzocco, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95008622 Issued in CA

Practice address

25825 Vermont Ave
Harbor City, CA 90710-3518

Phone

(310) 517-6441

NPI assigned

May 7, 2018

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

Other names 1

• Lisa Nicole Ortega Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1972092781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13423 OCEAN GATE AVE",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902505611",
            "telephone_number": "310-643-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-517-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOCCO",
        "first_name": "LISA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95008622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "ORTEGA",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie Naomi Matsunaga-Taylor, RCP
• Robert J Matsushima, OD
• Daisha Joyce Matthews
• Marilyn Mayeda
• Rosie Marie Mayfield
• Kerry MC Cabe, CNM
• Michelle R McCladdie, AUD
• Keisha La Juan McCray, MA, CCC-SLP
• W. Dwayne McElwee, CMPSS
• Dwight F McGregor, LVN

• Acute Care Nurse Practitioner in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.