Healthcare Provider Details

I. General information

NPI: 1326986142
Provider Name (Legal Business Name): LISA ALEXANDRIA RANGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 MUIR RD
MARTINEZ CA
94553-4668
US

IV. Provider business mailing address

2769 WEXFORD DR
CONCORD CA
94519-1642
US

V. Phone/Fax

Practice location:
  • Phone: 925-372-2000
  • Fax:
Mailing address:
  • Phone: 925-300-7072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN95294325
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: