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General NPI Number Information
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NPI Number | 1215114426
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Entity Type | Individual
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Provider Name | ELIZABETH ANN LOVERSO PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 31755 DATE PALM DR
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-3101
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Country | US
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Telephone | 760-770-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 1327 VIA PALMERA
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City | CATHEDRAL CITY
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State | CA
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Zip | 92234-4394
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Country | US
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Telephone | 812-470-1745
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 001881
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA61570
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 10001974A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 00610
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-08736
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License Number State | NC
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