Provider Demographics
NPI:1639131600
Name:RHODE, LISA J (NP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:RHODE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:6058 ALEXANDRA CT
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-5834
Mailing Address - Country:US
Mailing Address - Phone:818-865-8002
Mailing Address - Fax:
Practice Address - Street 1:7325 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1925
Practice Address - Country:US
Practice Address - Phone:818-226-3666
Practice Address - Fax:818-992-6853
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2012-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN396332363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS61616Medicare UPIN