LISA RANDOLPH


Address: 1010 Murray Ave, San Luis Obispo, CA 93405-1806
Phone: 8055467600

LISA RANDOLPH (NPI# 1114393279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1114393279
Entity Type Individual
Full Name LISA RANDOLPH
Other Name LISA M ECKER
Practice Address 1010 Murray Ave
San Luis Obispo
CA 93405-1806
Mailing Address 4562 Obispo Rd
Atascadero
CA 93422-1531
Practice Telephone 8055467600
Enumeration Date 2015-08-12
Last Update Date 2015-08-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
95002336 CA Physician Assistants & Advanced Practice Nursing Providers

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1336538123 Lisa Randolph Marriage & Family Therapist 7121 Grand Prairie Dr, Colorado Springs, CO 80923-8763 2015-01-15
1831418771 Lisa Hydilya Randolph Specialist 1923 State St, Harrisburg, PA 17103-1641 2010-05-17
1447572466 Lisa Randolph Physician Assistant 408 Crain Hwy S Ste 7, Glen Burnie, MD 21061-3661 2010-02-17

Office Location

Street Address 1010 MURRAY AVE
City SAN LUIS OBISPO
State CA
Zip Code 93405-1806

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083687354 Paul J Wolfrom Anesthesiology 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2006-02-08
1306498464 Megan Christine Smith Registered Nurse 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2019-07-09
1982102000 Shilpa Patel Pharmacist 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2018-01-23
1326572116 Christopher Walheim Hospitalist 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2017-04-18
1285088211 Cindy Hsiang Su Hospitalist 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2016-04-15
1780046243 Olga Grigorieva Olson Hospitalist 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2016-03-24
1568856474 Kyle Richard Kelson Emergency Medicine 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2015-03-28
1154736734 Sean Andrews Emergency Medicine 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2014-06-23
1801210026 Justin Keadle Physician Assistant 1010 Murray Ave, San Luis Obispo, CA 93405-1806 2014-02-07
1801235320 John Lee Bass Nurse Practitioner 1010 Murray Ave, Trauma & Emergency Surgery, Svrmc, San Luis Obispo, CA 93405-1806 2013-06-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164076626 Hilary Abbott Anderson Physician Assistant 127 Casa St., San Luis Obispo, CA 93405 2019-08-01
1811465834 Fatemeh Ladan Ahmadinia Dentist 764 N Santa Rosa St, San Luis Obispo, CA 93405 2018-11-07
1538559794 Arnold Martin Horwitz Marriage & Family Therapist 1605 Garnette Drive, San Luis Obispo, CA 93405 2015-01-27
1750794764 Solmaz Naghsh Pharmacist 765 Foothill Blvd, San Luis Obispo, CA 93405 2014-06-06
1609293471 Robert S. Flores Dmd, Inc Dentist 878 Boysen Avenue, San Luis Obispo, CA 93405 2014-03-18
1457776445 Laura Anne Wilvert Marriage & Family Therapist 793 E. Foothill Blvd, Suite A, #278, San Luis Obispo, CA 93405 2014-02-27
1497181200 Tracey Ruby Madrigal Counselor 1106 Oceanaire Dr. #25, San Luis Obispo, CA 93405 2013-09-25
1437597572 Sarah Michelle Brenis Counselor 524 Princeton Place, San Luis Obispo, CA 93405 2013-06-11
1013350974 Jenna Rose Ramos Counselor 1459 Descanso St., San Luis Obispo, CA 93405 2013-04-10
1700140696 Christopher Dieterich Marchand Social Worker 793a E. Foothill Blvd, 190, San Luis Obispo, CA 93405 2012-06-26
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134749898 Kristy Clemons Nurse Practitioner 2102 Broad St, San Luis Obispo, CA 93401-5205 2020-04-23
1215593850 Emerald Mcleod Nurse Practitioner 1242 Monterey St Ste 130, San Luis Obispo, CA 93401-0808 2019-05-18
1932632957 Janna Tyler Nurse Practitioner 1030 Southwood Dr, San Luis Obispo, CA 93401-5813 2017-04-06
1346621547 Katherine Silva Nurse Practitioner 825 El Capitan Way, Apt 24, San Luis Obispo, CA 93401-8944 2015-06-12
1275739245 Nancy J Walden Nurse Practitioner Cal Poly State Health Center, 1 Grand Ave Building 27, San Luis Obispo, CA 93407-0210 2007-06-26
1164415501 Marya Mei Bolyanatz Nurse Practitioner 1250 Peach Street, Suite A, San Luis Obispo, CA 93401-2837 2005-08-30
1013541895 Michele L Day-brooks Nurse Practitioner 705 Grand Ave, San Luis Obispo, CA 93401-2639 2020-03-02
1528690278 Erin E Green Nurse Practitioner 1531 Higuera St, San Luis Obispo, CA 93401-2917 2020-02-11
1912546045 Cynthia Schenk Nurse Practitioner 1585 Kansas Ave, San Luis Obispo, CA 93405-7604 2020-01-06
1942761945 James Sellers Nurse Practitioner 1304 Ella St Ste A, San Luis Obispo, CA 93401-4165 2019-03-31
Find all providers in SAN LUIS OBISPO

Competitor

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City SAN LUIS OBISPO
Zip Code 93405

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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