Provider Demographics
NPI:1568995454
Name:VERA, LISBETH
Entity Type:Individual
Prefix:MRS
First Name:LISBETH
Middle Name:
Last Name:VERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31300 HIGHLAND CT
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7683
Mailing Address - Country:US
Mailing Address - Phone:951-961-4224
Mailing Address - Fax:
Practice Address - Street 1:31300 HIGHLAND CT
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-7683
Practice Address - Country:US
Practice Address - Phone:951-961-4224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor