Healthcare Provider Details

I. General information

NPI: 1225944358
Provider Name (Legal Business Name): LISA LEFRAK NEWBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4314 PIEDMONT AVE
OAKLAND CA
94611-4716
US

IV. Provider business mailing address

4631 DOLORES AVE
OAKLAND CA
94602-1823
US

V. Phone/Fax

Practice location:
  • Phone: 510-207-3559
  • Fax:
Mailing address:
  • Phone: 510-207-3559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: