Lisa Marie Fann, B.A., M.A.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

5302 Annie Laurie LN
Bonita, CA 91902-2713

Phone

(619) 212-5711

NPI assigned

Dec 7, 2016

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

Credentials

Bachelor of Arts, Master of Arts

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621123200000",
    "number": "1982148086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14248 LYONS VALLEY RD APT 2",
            "city": "JAMUL",
            "state": "CA",
            "postal_code": "919351810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5302 ANNIE LAURIE LN",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919022713",
            "telephone_number": "619-212-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "B.A., M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2021-05-16",
        "certification_date": "2021-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Alaine Dumstorff, PHARM. D.
• Lilinda Cruz Enano, DMD
• Carlos Manuel Espana, DDS
• Bette Ann Evenson
• Fabriel D Burquez
• Ashley Farwick
• Steven H Ferriot, DDS
• Katarina Fray, MA, MS, CCC-SLP
• Joel Villamil Gabriel, L.AC.
• Sivathilaka S Ganesh, MD

• Speech-Language Pathologist in Bonita, CA
• Providers in Bonita, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2021; 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.