Individual
LISA MARIE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1010 W LA VETA AVE STE 750, ORANGE, CA 92868-4312
(714) 361-6600
(714) 919-8804
Mailing address
1010 W LA VETA AVE STE 750, ORANGE, CA 92868-4312
(714) 361-6600
(714) 919-8804
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
NP19437
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912919804
TYPE 2 NPI
CA
05
—
1912919804
—
CA
01
—
CG5665
RAILROAD MEDICARE GROUP PTAN
CA
01
—
P01438733
RAILROAD MEDICARE PROVIDER PTAN
CA
Enumeration date
06/16/2010
Last updated
07/21/2022
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