Lysette Nana Etti

Primary specialty

Social WorkerTaxonomy code 104100000X

License

24469 Issued in CA

Practice address

31681 Riverside Dr
Suite L
Lake Elsinore, CA 92530-7815

Phone

(951) 674-9243

NPI assigned

Sep 6, 2007

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mindshift Psychological Services Inc

  • Marriage & Family Therapist
  • Corona, CA
  • NPI 1124656194
  Medicare reassignment NPD

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1992990519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31681 RIVERSIDE DR",
            "address_2": "SUITE L",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307815",
            "telephone_number": "951-674-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31681 RIVERSIDE DR",
            "address_2": "SUITE L",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307815",
            "telephone_number": "951-674-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTI",
        "first_name": "LYSETTE",
        "middle_name": "NANA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "24469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Espinoza, RD, CDCES
• Venus Esquivel, MD
• Alidiuska Estopinan Marzo
• Eileen Estrada, LVN
• Elizabeth Ivonne Estrada, APCC
• Edil Evangelista, MSN RN PHN FNPC CCRN
• Donna Evelyn, PH.D.
• Ever Ready Home Care Service LLC
• Everlast Assisted Living LLC
• Everlasting Assisted Living

• Social Worker in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.