Moran, Lisa Ann

Moran, Lisa Ann is an individual health care provider with primary practice located at 2225 Challenger Way , Santa Rosa CA 95407-5441. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Moran, Lisa Ann can be contacted via phone (707) 565-4970.

Contact Information

Primary practice address
2225 Challenger Way Santa Rosa CA 95407-5441
Phone: (707) 565-4970
Fax: (707) 565-5183
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD24266 Oregon

Profile Details

NPI number 1154399723
LBN Legal business name Moran, Lisa Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated Dec 26th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154399723 NPPES
Oregon MEDICAID 276098

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