=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558253831
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISA JAMES MSN, FNP-C, RN, CNL,
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/19/2025
-----------------------------------------------------
Last Update Date | 07/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 421 N BROOKHURST ST STE 224
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92801-5600
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-442-3947
-----------------------------------------------------
Fax | 714-442-3921
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 120 N MAGNOLIA AVE APT 53
-----------------------------------------------------
City | ANAHEIM
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92801-6449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-891-4007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 95035728
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------