Provider Demographics
NPI:1619195245
Name:SHEEHAN, LISA CATHERINE (RN , NP)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:CATHERINE
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:RN , NP
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Mailing Address - Street 1:333 TWIN OAKS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92096-0001
Mailing Address - Country:US
Mailing Address - Phone:442-444-0750
Mailing Address - Fax:888-800-8226
Practice Address - Street 1:333TWIN OAKS VALLEY RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92096-0001
Practice Address - Country:US
Practice Address - Phone:442-444-0750
Practice Address - Fax:888-800-8226
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA372035363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA363L00000XOtherRN372035 CA NP 7420