Healthcare Provider Details

I. General information

NPI: 1932305224
Provider Name (Legal Business Name): LISA MARIE KLIMPEL CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 09/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23741 VIA EL ROCIO
MISSION VIEJO CA
92691-3533
US

IV. Provider business mailing address

23741 VIA EL ROCIO
MISSION VIEJO CA
92691-3533
US

V. Phone/Fax

Practice location:
  • Phone: 949-916-4690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number16676
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: