DR. LISA R. PONFICK (NPI# 1962416255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962416255 |
| Entity Type | Individual |
| Full Name | DR. LISA R. PONFICK |
| Credential | M.D. |
| Practice Address |
4290 Polk Avenue San Diego CA 92105-1524 |
| Mailing Address |
Po Box 5539 2755 Colonial Drive Helena MT 59604-5539 |
| Practice Telephone | 6195630507 |
| Practice Fax Number | 6195630015 |
| Mailing Telephone | 4064447577 |
| Mailing Fax Number | 4064447588 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2020-02-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
23244 | MT | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
A86598 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
4290 POLK AVENUE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92105-1524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710932876 | Sheryl Lynn Parker | Registered Nurse | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2006-05-24 |
| 1063856805 | Elaine Rose Ocampo | Registered Nurse | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2013-04-23 |
| 1770893620 | Paula Elaine Engel | Registered Nurse | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2010-10-13 |
| 1376851378 | Tammie L Goulart | Registered Nurse | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2010-09-24 |
| 1366768525 | Jillion T. Harris | Family Medicine | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2010-04-13 |
| 1659609600 | Thanh Lam Nguyen | Registered Nurse | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2009-12-03 |
| 1013245067 | Linnea Belle Daley | Registered Nurse | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2009-12-03 |
| 1780816082 | Amelia Shamsi Polheber | Nurse Practitioner | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2009-08-20 |
| 1922237809 | Shawna Akiko Hirata Johnson | Nurse Practitioner | 4290 Polk Avenue, San Diego, CA 92105 | 2009-07-13 |
| 1114177060 | Sharon Elizabeth Aswegan | Registered Nurse | 4290 Polk Avenue, San Diego, CA 92105-1524 | 2008-09-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851934798 | Point Loma Nazarene University | Nurse Practitioner | Point Loma Nazarene University Health Promotion Center, 4101 University Avenue, San Diego, CA 92105 | 2019-10-23 |
| 1104478809 | Kristin Lynn Nichols | Counselor | 4823 El Cajon Blvd Suite #115, San Diego, CA 92105 | 2019-07-12 |
| 1205343076 | Momentum Learning | Counselor | 3720 El Cajon Blvd., Sd, CA 92105 | 2018-01-03 |
| 1306352695 | Nathan Hien Le, Dds. Inc | Dentist | 4170 Fairmount Ave., San Diego, CA 92105 | 2017-12-21 |
| 1073038071 | Aika Mary Erlandson | Student in an Organized Health Care Education/Training Program | 5296 University Ave. Suite F-2, San Diego, CA 92105 | 2017-08-10 |
| 1457872178 | Ride-in Transport LLC | Non-emergency Medical Transport (VAN) | 4061 Fairmount Ave, San Diego, CA 92105 | 2017-07-03 |
| 1598205346 | Ahmed Mooge | Ambulance | 4061 Fairmout Ave, San Diego, CA 92105 | 2017-02-27 |
| 1083152748 | Rady Childrens Hospital-san Diego | Psychiatric Unit | 4305 University Avenue, Suite 150, San Diego, CA 92105 | 2017-02-02 |
| 1730634098 | Med Specialty Sai Inc. | Pharmacy | 4153 University Avenue, Suite B, San Diego, CA 92105 | 2016-08-16 |
| 1568857464 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 4074 Fairmount Avenue, Suite B, San Diego, CA 92105 | 2015-03-30 |
| Find all providers in zip 92105 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255951620 | Dymphna San Diego Tms Inc | Psychiatry & Neurology | 10850 Baroque Ln Ste A, San Diego, CA 92124-3029 | 2020-04-25 |
| 1316581846 | Botkiss Center for Recovery | Psychiatry & Neurology | 12625 High Bluff Dr Ste 301, San Diego, CA 92130-2054 | 2019-10-28 |
| 1447746169 | Jack Perlov | Psychiatry & Neurology | 3535 Caminito El Rincon, Unit 268, San Diego, CA 92130 | 2018-07-05 |
| 1629501770 | Amanda Suzette Freitas | Psychiatry & Neurology | 11634 Maroon Peak Ct, San Diego, CA 92131-3846 | 2017-04-06 |
| 1114312147 | Jaclyn Joyce | Psychiatry & Neurology | 3344 4th Ave Ste 100, San Diego, CA 92103-5704 | 2015-04-07 |
| 1326433525 | Azin Khazaeli | Psychiatry & Neurology | 4445 Eastgate Mall Fl 2, San Diego, CA 92121-1979 | 2015-04-03 |
| 1083054639 | Kiran Sufian Munir | Psychiatry & Neurology | 8170 Miramar Rd, San Diego, CA 92126-4321 | 2013-06-27 |
| 1457799462 | Charles Howard Merideth | Psychiatry & Neurology | 8889 Rio San Diego Dr, Suite 103, San Diego, CA 92108-1670 | 2013-06-12 |
| 1114363876 | Safi Ahmed | Psychiatry & Neurology | 200 W Arbor Dr # 8809, San Diego, CA 92103-1911 | 2013-05-21 |
| 1639515364 | Paul Joseph Smith | Psychiatry & Neurology | 12520 High Bluff Dr Ste 135, San Diego, CA 92130 | 2013-05-21 |
| Find all providers in SAN DIEGO | ||||
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| 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.