MEDICARE: JO ANN C PRESTON LISAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LISAC-1578	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457493645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JO ANN C PRESTON LISAC

Provider Business Mailing Address
First Line	:	2380 W SAN XAVIER RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85746-7238
Country	:	US
Telephone Number	:	520-879-6060
Fax Number	:	520-879-6099

Provider Business Practice Location Address
First Line	:	7490 S CAMINO DE OESTE
Second Line	:	7402 S. CAMINO VAHCOM
City	:	TUCSON
State	:	AZ
Zip	:	85746-9308
Country	:	US
Telephone Number	:	520-879-6060
Fax Number	:	520-879-6099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	11/30/2025

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Directions to “ JO ANN C PRESTON LISAC” Practice Location

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