MEDICARE: LISA NEUMANN BHP, CADC-II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	61308	OTHER	CA	CPC
2	A048601217	OTHER	CA	CADC-II
3	01011528T	OTHER	OH	BHP
4	11-11-T-621-2011-P12	OTHER	CA	THETAHEALING PRACTITIONER

General Provider Information

NPI Number	:	1649805821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA NEUMANN BHP, CADC-II

Provider Business Mailing Address
First Line	:	33152 PASEO PINTO
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-4621
Country	:	US
Telephone Number	:	949-838-7905
Fax Number	:

Provider Business Practice Location Address
First Line	:	32301 CAMINO CAPISTRANO STE J
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-4512
Country	:	US
Telephone Number	:	949-220-2373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2020
Last Update Date	:	03/07/2020

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