LISA LYNN PASSALACQUA (NPI# 1275140550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275140550 |
| Entity Type | Individual |
| Full Name | LISA LYNN PASSALACQUA |
| Credential | PA-C |
| Practice Address |
431 7th St Norco CA 92860-1671 |
| Practice Telephone | 9512754987 |
| Mailing Telephone | 9512754987 |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
58543 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
431 7TH ST |
| City | NORCO |
| State | CA |
| Zip Code | 92860-1671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104466119 | Julie Chang | Pharmacist | 1101 Hidden Valley Parkway, Norco, CA 92860 | 2020-01-08 |
| 1629629241 | Abbey West Transportation LLC | Non-emergency Medical Transport (VAN) | 1791 Third St, Norco, CA 92860 | 2019-09-25 |
| 1457906745 | Corrections and Rehabilitation | Pharmacy | 5th and Western Ave, Module M, Room #104, Norco, CA 92860 | 2019-08-05 |
| 1942713417 | Pakravan Dental Corporation | Dentist | 2440 River Road, Suite 140, Norco, CA 92860 | 2017-11-07 |
| 1003202938 | Christina Cowell | Dental Assistant | 4033 Bluff St, Noroc, CA 92860 | 2015-04-07 |
| 1811301575 | Kenneth John Conlan | Counselor | 630 Winchester Dr., Norco, CA 92860 | 2014-06-19 |
| 1336489384 | Hyangsook Jung | Psychologist | 5th St. and Western Ave., Norco, CA 92860 | 2013-02-27 |
| 1386913275 | Shirley Nguyen | Pharmacist | 5th Street & Western Avenue, Norco, CA 92860 | 2011-12-21 |
| 1609168301 | Nicole Nadine Ortiz | Occupational Therapist | 2820 Clark Ave., Norco, CA 92860 | 2011-05-12 |
| 1861793739 | Peter A Petito | Psychologist | 5th and Western Ave., California Rehabilitation Center, Norco, CA 92860 | 2010-11-09 |
| Find all providers in zip 92860 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720421779 | Randi Lee Holmes | Physician Assistant | 4232 Cedar Ave, Norco, CA 92860-1216 | 2013-04-09 |
| 1770750788 | Fernando Hool | Physician Assistant | 1860 Hamner Ave, Norco, CA 92860-2945 | 2008-05-09 |
| 1093196578 | Veronica D Spencer | Physician Assistant | 1860 Hamner Ave, Norco, CA 92860-2945 | 2015-06-10 |
| 1528395365 | Tim Richard Doren | Physician Assistant | 1901 Town and Country Dr, Norco, CA 92860-3611 | 2009-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1275144313 | Sofia Carmen Bustillo | Physician Assistant | 1709 Coral Pl, Seal Beach, CA 90740-5712 | 2020-08-12 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| 1316573843 | Roberto Emiliano Meraz Nunez | Physician Assistant | 6642 Fulton Ave, Van Nuys, CA 91401-1312 | 2020-03-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.