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General NPI Number Information
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NPI Number | 1033323183
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Entity Type | Individual
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Provider Name | LISA BERTOTTI RN-NP
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2605 CARLSBAD BLVD
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City | CARLSBAD
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State | CA
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Zip | 92008-2208
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Country | US
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Telephone | 760-547-5215
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Fax | 760-720-2349
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Provider Business Mailing Address
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Address Line | 2586 HIGHLAND DR
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City | CARLSBAD
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State | CA
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Zip | 92008-1025
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Country | US
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Telephone | 760-434-2570
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 458124
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License Number State | CA
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