Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
LISA LEAH SHOSHANNA NOSHAY PETRO
Active
Individual
LISA LEAH SHOSHANNA NOSHAY PETRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
116737
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01536011
MEDICAL
—
01
—
116737
BOARD OF BEHAVIORAL SCIENCE
CA
Enumeration date
10/04/2023
Last updated
10/04/2023
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