Healthcare Provider Details

I. General information

NPI: 1336928340
Provider Name (Legal Business Name): LISA ESPLANA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30156 LEXINGTON DR
CASTAIC CA
91384-4622
US

IV. Provider business mailing address

30156 LEXINGTON DR
CASTAIC CA
91384-4622
US

V. Phone/Fax

Practice location:
  • Phone: 661-310-6360
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95026208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: