Healthcare Provider Details

I. General information

NPI: 1326692708
Provider Name (Legal Business Name): LIA ARMSTRONG WYSTRACH BSN, RN, MN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LIA MARGUERITE ARMSTRONG

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LARKSPUR LANDING CIR STE 10
LARKSPUR CA
94939-1836
US

IV. Provider business mailing address

4114 NE ROYAL CT APT A
PORTLAND OR
97232-2677
US

V. Phone/Fax

Practice location:
  • Phone: 415-924-1214
  • Fax:
Mailing address:
  • Phone: 650-576-2558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201906215NP-PP
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95035870
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: