Provider Demographics
NPI:1164546404
Name:GARBER, LISA A (CNM)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:A
Last Name:GARBER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 EAST CENTER AVE.
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6331
Mailing Address - Country:US
Mailing Address - Phone:559-737-4700
Mailing Address - Fax:559-737-4782
Practice Address - Street 1:1107 WEST POPLAR AVENUE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93291-5839
Practice Address - Country:US
Practice Address - Phone:559-781-7242
Practice Address - Fax:559-793-3542
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301370367A00000X
CA1108176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANMW1108Medicaid
CAP56413Medicare UPIN
CAZZZ02024ZMedicare ID - Type UnspecifiedNURSE MIDWIFE