Individual
LISA DENG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
1551 BISHOP ST STE 310, SAN LUIS OBISPO, CA 93401-4637
(805) 242-4455
(805) 542-9589
Mailing address
1241 JOHNSON AVE # 322, SAN LUIS OBISPO, CA 93401-3306
(805) 242-4455
(805) 542-9589
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95001507
CA
363LA2200X
Adult Health Nurse Practitioner
95001507
CA
363LG0600X
Gerontology Nurse Practitioner
95001507
CA
Other
Enumeration date
11/12/2014
Last updated
05/05/2016
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