Provider Demographics
NPI:1447849252
Name:ARIAS, LISA R (LVN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:R
Last Name:ARIAS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 M ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1808
Mailing Address - Country:US
Mailing Address - Phone:559-264-2700
Mailing Address - Fax:
Practice Address - Street 1:1310 M ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1808
Practice Address - Country:US
Practice Address - Phone:559-264-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35388164X00000X, 167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician
No164X00000XNursing Service ProvidersLicensed Vocational Nurse