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NPI Code Detail

MEDICARE: LISA ANNE DAWES RD

MEDICARE: LISA ANNE DAWES RD
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
1133V00000XRegistered Dietitian883324CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1GB179ZOTHERCAMEDICARE ID

General Provider Information

NPI Number : 1982687851
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANNE DAWES RD
Provider Business Mailing Address
First Line : 510 N VIA BELMONTE CT
Second Line :
City : ARROYO GRANDE
State : CA
Zip : 93420-4024
Country : US
Telephone Number : 805-316-5113
Fax Number : 805-270-4534
Provider Business Practice Location Address
First Line : 107 NELSON ST
Second Line :
City : ARROYO GRANDE
State : CA
Zip : 93420-3318
Country : US
Telephone Number : 805-316-5113
Fax Number : 805-270-4534
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 04/09/2026

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