Provider Demographics
NPI:1497048250
Name:SCHRODI, LISA MARIE (PA)
Entity Type:Individual
Prefix:MISS
First Name:LISA
Middle Name:MARIE
Last Name:SCHRODI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1232 E WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-5004
Mailing Address - Country:US
Mailing Address - Phone:714-401-7932
Mailing Address - Fax:
Practice Address - Street 1:5475 E LA PALMA AVE STE 100
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2001
Practice Address - Country:US
Practice Address - Phone:714-970-0911
Practice Address - Fax:714-970-0604
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21417363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant